Staph Infection Symptoms

Staph Infection Symptoms

Staph infection symptoms include various skin changes, symptoms related to infected internal organs, and symptoms relateed to staph blood poisoning – sepsis.

What is Staph?

Staph infection is caused by bacterium Staphylococcus aureus (shortly staph), and rarely by S. epidermidis or other staphylococcal species.

What is Staph Infection?

Staph infection is inflammation of the skin or internal organs, caused by staph bacteria or their toxins. Staph infection may be mild or life threatening, and may appear as:

• staph skin infection
• staph infection of mucous membranes (sinusitis, epiglottitis, vaginitis)
• staph gland infections (mastitis, parotitis) 
• staph food poisoning
• staph urinary infection in men
• staph bone infection (osteomielitis) and joint infection (arthritis)
• staph pneumonia
• bacterial endocarditis
• staph meningitis
• bacteremia, septicemia
• soft tissue gangrene and gas gangrene
• staphylococcal toxic shock syndrome

Symptoms of Staph Skin Infection

Staph skin infection may appear as a:

• red skin rash or pus filled blisters (folliculitis) folliculitis pictures
• red bump or swelling on the eyelid (stye)
• vesicles which burst and crust over (impetigo)
• painful red swelling or vesicle around the nail (paronychia)
• painful red nodules which may drain pus (boils: furuncle, carbuncle)
• swollen red skin patch, usually on limbs (cellulitis)
• skin scalding, mostly in young children (staphylococcal scalding skin syndrome)
• infected acne, hydradenitis suppurativa, or pilonidal cyst
• infected wound, and related infection of lymphatic vessels (staphylococcal lymphangitis)

Detailed description of staph skin infections with pictures   

Symptoms of Staph Mastitis

Staph mastitis is an inflammation of mammary gland and mostly occurs in breastfeeding mothers within 6 weeks after childbirth, or sometimes later(1). Symptoms of mastitis may include:

• red, warm, tender or painful swelling or a lump in the breast (usually only on one side)
• breast skin and nipple itching
• nipple discharge
• fever over 38.3°C (101°F), feeling ill 
• tender or enlarged lymph nodes in related armpit

Symptoms of Bacterial Parotitis

Bacterial parotitis is an inflammation of parotid gland (salivary gland which lies under the skin below the ear) caused by staph or other bacteria. It usually occurs in old, dehydrated patients, or those who were intubated (2). Bacterial parotitis has to be distinguished from viral parotitis which mostly occurs in children. Both types are usually one-sided, and both are rare. Symptoms of bacterial parotitis usually include:

• painful swelling bellow the ear on one side
• painful mouth opening (trismus) and swallowing (dysphagia)
• purulent discharge into the mouth
• high fever with chills

Staph Food Poisoning Symptoms

When a person who prepares food has staphylococci in the nose (staph carrier) or has staph skin infection, some bacteria may end up in the food. If such a food is kept outside the refrigerator for few hours, bacteria may produce enough toxins to cause food poisoning. 

Symptoms of staph food poisoning are:

• nausea and vomiting which may appear between 30 minutes and 8 hours after food ingestion
• rarely diarrhea or fever follow the vomiting

The illness usually lasts for one to three days, and resolves on its own.

Bacterial Sinusitis Symptoms

Bacterial sinusitis is an inflammation of mucosa which covers the inner surfaces of bone cavities around the nose. It may be caused by staph or other bacteria. 

Symptoms usually include:

• pain in cheeks, teeth, or forehead
• blocked nose, changed smell, sticky greenish nose discharge, bad breath, and rarely fever
• high fever, face swelling, severe headache, neck stiffness, and confusion are symptoms of severe sinusitis - in these cases doctor should be visited promptly

Bacterial sinusitis usually lasts for more than 10 days, while viral sinusitis usually resolves in few days on its own.

Bacterial Epiglottitis Symptoms

Epiglottis is a cartilage on the base of the tongue, which prevents the entrance of food into the larynx during swallowing. Injury of epiglottis’s mucosa may be followed by severe, life threatening staph infection, characterized by:

• sudden severe pain in the throat
• painful swallowing
• excessive salivating
• difficult breathing, air hunger
• high fever

Bacterial epiglottitis is rare, mostly seen in young children, but can also affect adults (3).

Staph Vaginitis Symptoms

Symptoms of staph vaginitis may include:

• purulent discharge (blood may be present) with bad (fishy) odor
• pain during intercourse or urinating
• vaginal itching

Symptoms of Bacterial Urinary Infection in Men

Various staphylococci species and other bacteria may cause infection of urinary system in a male.

Common symptoms are:

• burning pain during urination, urinary frequency, and urgency.

Symptoms of bacterial prostatitis:

• pain in the perineum, testicles, penis, or lower abdomen
• cloudy urine, rarely blood in the semen
• fever and muscular pain.

Kidney infection (pyelonephritis) and infection of the bladder (cystitis) are characterized by:

• pain over the kidney(s), lower abdominal or lower back pain (in cystitis)
• cloudy urine
• fever with chills. 

Urethritis, epididymitis, orchitis and urinary infections in women are only rarely caused by staphylococci (4). 

Staph Bone Infection (Osteomyelitis) Symptoms

Staph bone infection (osteomyelitis) typically occur in children and most commonly affect the lower end of the thigh bone, the upper end of the lower-leg bone (tibia), upper-arm (humerus) or fore-arm (radius) bone. 

• Staph osteomyelitis is often without any symptoms. When infection was due to injury,  skin redness, swelling or ulcer may be seen on the site of injury. Strong pain, and fever are common. Mobility of the limb is usually affected. Lymph nodes lying between bone infection and heart may be swollen (5). Ulcer may heal slowly and drain pus. Infection may spread into adjacent joint.

When staphylococci reach the bones by blood (hematogenous spread),

• swelling, pain and redness may appear on the skin above the affected bone (including vertebra or pelvis - in older patients)  

Staph joint infection (arthritis) may arise from infection of adjacent bone, direct puncture of the joint (usually knee in children) or from hematogenous spread of staphylococci. 

Symptoms of staph artritis are:

• infected joint is swollen, red, warm and extremely tender (6)
• fever is common

Symptoms of Life Threatening Staph Infections

Staph Pneumonia Symptoms

Staphylococcal pneumonia typically occur in hospitalized patients (hospital acquired pneumonia) with underlying lung disease, intravenous drug addicts and persons with indwelling prosthetic devices (7). Symptoms don’t differ from pneumonia, caused by other bacteria, and usually include:

• high fever, chills, difficult breathing, increased heart rate, cough, and sometimes bluish skin. Prognosis is poor.

Bacterial (Staph) Endocarditis Symptoms

Staph endocarditis usually results from spread of Staphylococcus aureus from the skin in intravenous drug users, or in children with inborn heart disease, prosthetic valves, or after catheterization or surgery. Symptoms of bacterial endocarditis are nonspecific and may include:

• fever, rarely exceeding 39°C
• paleness
• fatigue, night sweating, joint/muscular pain
• splinter hemorrhage under nails, red skin spots on the palms and soles (Janeway lesions), red, painful nodes on the fingers and toes (Osler’s nodes), tiny mucosal bleeding (petechia) in eye conjunctiva (8) 
• with a sthetoscope heart murmurs may be sometimes heard (8) 

Symptoms of complications of bacterial endocarditis:

• in acute heart failure breathlessness, leg and belly swelling, enlarged liver and spleen may appear
• in stroke muscular activity and sensations may be affected

Staph Meningitis Symptoms

Staphylococcal meningitis may occur in patients who had brain surgery or those with heavy skin infections.

Symptoms are like in meningitis caused by other bacteria:

• low grade fever, headache, lethargy, confusion (9).

Signs of meningeal irritation like neck stiffness are usually not present (9). 

Bacteremia, Septicemia

Bacteremia is presence of bacteria in blood. Bacteria may enter the blood from the site of infection like pneumonia or meningitis, during inserting vascular catheters, drug administration, surgery, tooth extraction etc. Temporary bacteremia may follow teeth brushing or entering of bacteria from the intestine, and it’s not dangerous since bacteria are quickly destroyed when they pass the liver (11). Symptoms of bacteremia include only

• fever, or middle ear infection (in children), but no other symptoms (10).

Tooth extraction in a patient who has staphylococci in mouth and has congenital heart disorder or prosthetic heart valves, may lead to bacterial (staph) endocarditis.

Sepsis (inflammation of the blood) is symptomatic bacteremia (13). Staph sepsis is usually triggered by staph bacteria entering the blood  from existing infection, like infected skin burns. Sepsis may be life threatening condition. Symptoms of staph sepsis (11,12,13) are:

• sudden high fever with or without chills, or (often in infants) hypothermia in a patient with existing staph infection
• a person looks seriously affected, feels weak, and may have nausea, vomiting, or diarrhea
• rapid heart beat, rapid breathing
• symptoms arising from affected organs (osteomielitis, arthritis, meningitis, endocarditis, pericarditis etc) 

Septicemia may lead to shock with

• altered consciousness, hypothermia, red spots on the skin (from blood clothing), shallow breathing and decreased urination.

Necrotizing Soft Tissue Infections

Necrotizing soft tissue infection (necrotizing fasciitis, soft tissue gangrene)  is a rare, severe bacterial infection, caused by staphylococci, streptococci or other bacteria, which can destroy the muscles, skin, and underlying tissue (14).

• A small red spot or bump may appear on the skin and changes into a painful brownish, purple and finally black patch, which may ulcerate and drain fluid or pus. The wound may develop in less than an hour. General symptoms may resemble sepsis. Without treatment, death may follow quickly.

Gas Gangrene

Gas gangrene may develop in a wound infected with S. aureus or Clostridium perfringens bacteria, often in persons with atherosclerosis or diabetes. Gas gangrene differs from above mentioned soft tissue gangrene by the following symptoms:

• gas may be felt around the wound edges
• brownish-red skin patch or blisters may appear around the wound
• moderate pain and moderate fever develop

Toxic Shock Syndrome

Toxic shock syndrome is a severe illness caused by toxins released from S. aureus, and may follow any existing staph infection. It mostly occurs in women using tampons or diaphragm, or as a complication of nasal surgery, or staph wound infection (15).

Symptoms of toxic shock syndrome may include (15):

• sudden onset of high fever, vomiting, diarrhea, and muscle pains
• sunburn-like skin rash, which peels off in 1-2 weeks 
• shock may develop; disease is fatal in about 5% of cases

References:

1. http://www.nlm.nih.gov/medlineplus/ency/article/001490.htm MASTITIS
2. http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/parotitis.pdf PAROTITIS
3. http://www.emedicine.com/emerg/topic375.htm EPIGLOTTITIS
4. http://www.emedicine.com/MED/topic2346.htm URINARY INFECTIONS IN MEN
5. http://kidshealth.org/teen/infections/bacterial_viral/osteomyelitis.html OSTEOMYELITIS
6. http://www.orthop.washington.edu/uw/infectious/tabID__3376/ItemID__35/PageID__5/Articles/Default.aspx STAPH ARTHRITIS
7. http://www.merck.com/mmpe/sec05/ch052/ch052c.html HOSPITAL ACQUIRED PNEUMONIA
8. http://www.nlm.nih.gov/medlineplus/ency/article/001098.htm BACTERIAL ENDOCARDITIS SYMPTOMS
9. http://www.emedicine.com/neuro/topic352.htm STAPH MENINGITIS
10. http://www.emedicine.com/PED/topic196.htm BACTEREMIA
11. http://www.merck.com/mmhe/sec17/ch191/ch191b.html TEMPORARY BACTEREMIA, SEPSIS
12. http://www.nlm.nih.gov/medlineplus/ency/article/001355.htm SEPSIS
13. http://www.emedicine.com/med/topic3163.htm SEPSIS
14. http://www.nlm.nih.gov/medlineplus/ency/article/001443.htm SOFT TISSUE GANGRENE
15. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/toxicshock_t.htm TOXIC SHOCK SYNDROME