Young footballers dreaming of World Cup glory face an unexpected hazard on their journey to the top: the toxic boot.
Doctors report today on two cases in which youngsters developed toxic-shock syndrome, a potentially fatal condition that can sometimes be caused by wearing new football boots.
In one case a 13-year-old girl developed a fever and a rash covering the whole of her body, accompanied by vomiting and diarrhoea, after playing a game of football in a new pair of boots, which caused blisters on her Achilles tendons. In hospital, her condition deteriorated and her blood pressure fell. Doctors found pus from her blisters contained a strain of staphylococcus aureus, the common bacterium, carrying the toxic-shock syndrome gene.
In a second case an 11-year-old boy who developed a blister on his right heel after playing football in new boots was admitted to hospital with similar symptoms. His condition continued to deteriorate and he was transferred to the intensive care unit until his blood pressure stabilised.
After nine days recovering he was still covered with the rash and on his discharge the skin on his hands and feet peeled off.
Toxic-shock syndrome came to public attention in the 1980s when cases in adults were linked with a particular brand of tampon.
In children it is rare and mostly linked with skin burns when the strain of s. aureus carrying the toxic-shock syndrome gene can infect the wound.
Clive Graham, a consultant microbiologist at Birmingham Children's Hospital, and co-author of the report in the British Medical Journal, said there was no link between toxic-shock syndrome and any particular brand of football boot. "It was chance that these cases were infected with this nasty strain of s. aureus. The message for parents and children is to be careful when breaking in a new pair of boots."