This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci), Subject name: Microbiology
Staphylococcal scalded skin syndrome is caused by- 
Select and explain. 
A. Hemolysin, B. Coagulase, C. Enterotoxin, D. Epidermolytic toxin
D: Epidermolytic toxin
Answer: D: Epidermolytic toxin 
Explanation: Option 1 Hemolysin: RBC lysis Option 2 Clumping factor/Bound coagulase: Responsible for slide coagulase reaction. Option 3 Enterotoxins: Cause food poisoning. Option 4 Epidermolytic (Exfoliative toxin) toxins of S aureus are 2 distinct proteins Exfoliative toxin A- encoded by beta located on a phage, is heat stable. Exfoliative toxin B - plasmid mediated and heat labile. These toxins are superantigens causing: Scalded skin syndrome (Nikolsky's sign +ve) Severe- Ritter disease (newborn), toxic epidermal necrolysis (TEN) (adult) Milder- Pemphigus neonatorum, bullous impetigo