lnfection occurs during penetration of the skin (for example, due to a wound, or during surgery), typically rusulting in an abscess. Subsequent disease can be caused by the actual infection, by toxins in the absence of infection (toxinosis), or by a combination of infection andintoxication. lmportant S. aureus virulence factors include: 1) cell wall virulence factors that can promots binding to mucosal cells and exert antiopsonic (and, there-fore, antiphagocytic) effects; 2) cytolytic exotoxins (including hemolysins);and 3) superantigen exotoxins, including enterotoxins (which cause food poisoning), toxic shock syndrome toxin, and exfoliative (which causes scalded skin syndrome in children, and also bullous impetigo). The most common diseases caused by S. aureus are the following.