Why do some patients develop recurrent staphylococcal impetigo or recurrent

Recurrent infections occur when Staphylococcus aureus establishes itself as a part of the resident microbial flora. This occurs in up to 20% of individuals. The most common sites of carriage are the anterior nasal vestibule, axilla, groin, and feet. Patients who have virulent strains are prone to the development of recurrent impetigo or furunculosis, depending on the strain. A variety of host factors, such as abnormal neutrophil chemotaxis (e.g., hypergammaglobulinemia IgE syndrome), deficient intracellular killing (e.g., chronic granulomatous disease), and immunodeficiency states (e.g., AIDS), are important in a minority of patients. Diabetes mellitus is listed in many references as being associated with recurrent furunculosis, but this is controversial.

El-Gilany AH, Fathy H: Risk factors of recurrrent furunculosis, Dermatol Online J 15:16, 2009.