Staphylococcal scalded skin syndrome - Стафілакокавай Сіндром Апаранай Скуры
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Немаўля з Стафілакокавай Сіндром Апаранай Скуры (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome - гэта стан, пры якім скура ліняе з-за таксінаў, якія выпрацоўваюцца некаторымі тыпамі бактэрый стафілакока. Гэта рэдкасць у дзяцей старэйшых за шэсць гадоў. Гэта таксама можа адбыцца ў дарослых з аслабленай імуннай сістэмай або сур'ёзнымі праблемамі з ныркамі. Галоўная прыкмета - шырокае лушчэнне скуры пасля запалення. Ступень цяжкасці вар'іруецца ад некалькіх пухіроў да шырокай страты скуры, што можа выклікаць сур'ёзныя перапады тэмпературы цела і нестабільнасць артэрыяльнага ціску.
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
Staphylococcal scalded skin syndrome (SSSS) and bullous impetigo are infections caused by Staphylococcus aureus. Bullous impetigo is due to the local release of these toxins and thus, often presents with localized skin findings, whereas SSSS is from the systemic spread of these toxins, resulting in a more generalized rash and severe presentation. Both conditions are treated with antibiotics that target S. aureus. These conditions can sometimes be confused with other conditions that result in superficial blistering.
Звярнуўся хлопчык 10 месяцаў з насмаркам, дрэнна есць. Лекары сказалі, што гэта інфекцыя верхніх дыхальных шляхоў. Праз два дні ён вярнуўся, таму што яму не стала лепш і ў яго з'явіліся новыя праблемы, такія як апухлы твар і раздражнёная скура вакол рота. У наступныя два дні хлопчыку стала горш. У яго апухлі рукі і ногі, пачала злазіць скура. Яшчэ ў бальніцы лекары заўважылі чырвоную сып на яго твары і ў складках скуры, якая бляднела пры дакрананні. Яму паставілі дыягназ staphylococcal scalded skin syndrome (SSSS) і пачалі прымаць антыбіётыкі праз вену.
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
2-гадовая дзяўчынка з'явілася з сыпам па ўсім целе, якое з'явілася на працягу 48 гадзін пасля ўкусаў насякомых на твары напярэдадні. Падчас агляду ў яе была шырока распаўсюджаная сып, якая складаецца з невялікіх грудкоў, якія зліваліся разам, а пры лёгкім паціранні на яе скуры з'яўляліся прыкметы Нікольскага. Прыкмет сыпу на слізістых абалонках не было. Аналізы яе крыві не паказалі ніякіх прыкмет інфекцыі.
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.
Сіндром выклікаецца эпидермолитическими экзотоксіны (эксфолиатин) А і В, якія выдзяляюцца S. aureus. Прагноз стафілакокавай сіндром апаранай скуры (staphylococcal scalded skin syndrome) у дзяцей выдатны, з поўным знікненнем на працягу 10 дзён пасля лячэння і без значных рубцоў. Аднак стафілакокавай сіндром апаранай скуры (staphylococcal scalded skin syndrome) неабходна старанна дыферэнцаваць ад таксічнага эпідэрмальныя некролізу, які мае дрэнны прагноз.
○ Дыягностыка і лячэнне
Памылковая дыягностыка экзэмы, напрыклад атопіческій дэрматыт, і прымяненне стэроідных мазяў пагаршае паразы. Пры нанясенні мазі з антыбіётыкамі як мага хутчэй звярніцеся па медыцынскую дапамогу.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)