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An AIDS patient with the recalcitrant erythematous desquamating (RED) disorder, a presumed variant of the Staphylococcus aureus toxic shock syndrome that is characterized by relapses, skin involvement, and variable multiple-organ involvement, is described. A strain of S. aureus producing toxic shock syndrome toxin 1 was isolated from the patient, but no antibodies to this exotoxin were detectable before and during the most severe episode of the RED disorder. Levels of cytokines were measured during episodes and at other times. Tumor necrosis factor and interleukin 6 were detectable only during the most severe exacerbation of the disorder; this finding suggests a pathogenetic role for these cytokines.

Original publication




Journal article


Clin Infect Dis

Publication Date





942 - 945


Acquired Immunodeficiency Syndrome, Adult, Bacterial Toxins, Cytokines, Enterotoxins, Humans, Male, Receptors, Tumor Necrosis Factor, Shock, Septic, Staphylococcal Infections, Staphylococcus aureus, Superantigens, Tumor Necrosis Factor-alpha