Staphylococcal scalded skin syndrome - Staphylococcal Skaleret Hud Syndrom
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Et spædbarn med Staphylococcal Skaleret Hud Syndrom (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome er en tilstand, hvor huden falder på grund af toksiner produceret af visse typer stafylokokker. Det er ualmindeligt hos børn over seks. Det kan også forekomme hos voksne med svækket immunsystem eller alvorlige nyreproblemer. Hovedtræk er omfattende hudafskalning efter betændelse. Sværhedsgraden varierer fra nogle få blærer til udbredt hudtab, som kan forårsage alvorlige fald i kropstemperaturen og ustabilitet i blodtrykket.
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.
En 10-måneder gammel dreng kom ind med løbende næse og spiste dårligt. Lægerne sagde, at det var en øvre luftvejsinfektion. To dage senere kom han tilbage, fordi han ikke fik det bedre og havde nye problemer som hævet ansigt og irriteret hud omkring munden. I løbet af de næste to dage fik drengen det værre. Hans arme og ben hævede op, og hans hud begyndte at falde af. Tilbage på hospitalet bemærkede lægerne et rødt udslæt i hans ansigt og i hudfolderne, som blev blancheret ved berøring. De diagnosticerede ham med staphylococcal scalded skin syndrome (SSSS) og startede ham på antibiotika gennem en blodåre.
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.
En 2-årig pige dukkede op med udslæt over hele kroppen, som havde udviklet sig over 48 timer, efter insektbid i ansigtet dagen før. Under undersøgelsen havde hun et udbredt udslæt bestående af små knopper, der smeltede sammen, og ved let gnidning viste hendes hud tegn på Nikolsky-tegn. Der var ingen tegn på, at udslættet påvirkede hendes slimhinder. Tester på hendes blod viste ingen tegn på infektion.
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.
Syndromet induceres af epidermolytiske exotoksiner (exfoliatin)A og B, som frigives af S. aureus. Prognosen for staphylococcal skaleret hud syndrom (staphylococcal scalded skin syndrome) hos børn er fremragende, med fuldstændig opløsning inden for 10 dage efter behandling og uden signifikant ardannelse. staphylococcal skaleret hud syndrom (staphylococcal scalded skin syndrome) skal dog omhyggeligt differentieres fra toksisk epidermal nekrolyse, som har en dårlig prognose.
○ Diagnose og behandling
Fejldiagnosticering som eksemlæsioner såsom atopisk dermatitis og påføring af steroidsalve forværrer læsionerne. Søg lægehjælp så hurtigt som muligt, mens du påfører antibiotisk salve.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)