Staphylococcal scalded skin syndrome
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Beba sa Staphylococcal scalded skin syndrome
References
Staphylococcal Scalded Skin Syndrome je stanje u kojem se koža izlučuje zbog toksina koje proizvode određene vrste bakterija Staphylococcus. Neuobičajeno je kod djece starije od šest godina. Može se javiti i kod odraslih osoba sa oslabljenim imunološkim sistemom ili ozbiljnim problemima s bubrezima. Glavna karakteristika je intenzivno ljuštenje kože nakon upale. Ozbiljnost se kreće od nekoliko plikova do široko rasprostranjenog gubitka kože, što može uzrokovati ozbiljne padove tjelesne temperature i nestabilnost krvnog tlaka.
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.
Dječak od 10 mjeseci došao je sa curi iz nosa i nije dobro jeo. Doktori su rekli da je u pitanju infekcija gornjih disajnih puteva. Dva dana kasnije vratio se jer mu nije bilo bolje i imao je nove probleme poput otečenog lica i iritirane kože oko usta. U naredna dva dana dječaku se pogoršalo. Ruke i noge su mu natekle, a koža mu se skidala. Po povratku u bolnicu, ljekari su primijetili crveni osip na njegovom licu i naborima kože, koji je blijedio na dodir. Dijagnosticirali su mu staphylococcal scalded skin syndrome (SSSS) i dali mu antibiotike kroz venu.
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.
Djevojčica od dvije godine pojavila se s osipom po cijelom tijelu koji se razvio više od 48 sati, nakon ujeda insekata na licu dan ranije. Tokom pregleda, imala je raširen osip sastavljen od malih kvržica koje su se spajale, a kada se lagano trlja, njena koža je pokazivala znakove znaka Nikolskog. Nije bilo znakova da je osip zahvatio njene sluzokože. Testovi njene krvi nisu pokazali znakove infekcije.
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.
Sindrom je izazvan epidermolitičkim egzotoksinima (eksfoliatin)A i B, koje oslobađa S. aureus. Prognoza staphylococcal scalded skin syndrome kod djece je odlična, sa potpunim povlačenjem u roku od 10 dana nakon liječenja i bez značajnih ožiljaka. Međutim, staphylococcal scalded skin syndrome mora se pažljivo razlikovati od toksične epidermalne nekrolize, koja ima lošu prognozu.
○ Dijagnoza i liječenje
Pogrešna dijagnoza kao što su lezije ekcema kao što je atopijski dermatitis i primjena steroidne masti pogoršavaju lezije. Molimo Vas da potražite medicinsku pomoć što je pre moguće dok primenjujete antibiotsku mast.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)