Staphylococcal scalded skin syndrome - Stafülokoki Skaleeritud Naha Sündroom
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Imik, kellel on Stafülokoki Skaleeritud Naha Sündroom (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome on seisund, mille korral nahk eraldub teatud tüüpi Staphylococcus bakterite toodetud toksiinide tõttu. Üle kuueaastastel lastel on see haruldane. See võib ilmneda ka nõrgenenud immuunsüsteemiga või tõsiste neeruprobleemidega täiskasvanutel. Peamine omadus on põletikujärgne naha ulatuslik koorumine. Raskusaste ulatub mõnest villist kuni ulatusliku nahakaotuseni, mis võib põhjustada tugevat kehatemperatuuri langust ja vererõhu ebastabiilsust.
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.
10-kuune poiss tuli sisse nohuga ja halvasti söönud. Arstid ütlesid, et tegemist oli ülemiste hingamisteede infektsiooniga. Kaks päeva hiljem tuli ta tagasi, sest ta ei paranenud ja tal olid uued probleemid, nagu paistes nägu ja ärritunud nahk suu ümber. Järgmise kahe päeva jooksul läks poisil hullemaks. Tema käed ja jalad paistetasid üles ning nahk hakkas lahti tulema. Tagasi haiglasse jõudes märkasid arstid tema näol ja nahavoltides punast löövet, mis puudutamisel pleekisid. Nad diagnoosisid tal staphylococcal scalded skin syndrome (SSSS) ja alustasid talle veeni kaudu antibiootikume.
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-aastasel tüdrukul ilmnes kogu kehal lööve, mis oli tekkinud 48 tunni jooksul pärast putukahammustust eelmisel päeval. Läbivaatuse ajal oli tal laialt levinud lööve, mis koosnes väikestest muhudest, mis kokku sulasid ja kergelt hõõrudes ilmnesid tema nahal Nikolski märgi märgid. Mingeid märke tema limaskestadele mõjuvast lööbest ei ilmnenud. Tema vereanalüüsid ei näidanud nakkuse märke.
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.
Sündroomi kutsuvad esile epidermolüütilised eksotoksiinid (eksfoliatiin) A ja B, mida S. aureus vabastab. Lastel esineva stafülokoki skaleeritud naha sündroom (staphylococcal scalded skin syndrome) prognoos on suurepärane, taandub täielikult 10 päeva jooksul pärast ravi ja ilma märkimisväärsete armideta. Siiski tuleb stafülokoki skaleeritud naha sündroom (staphylococcal scalded skin syndrome) hoolikalt eristada toksilise epidermaalse nekrolüüsiga, mille prognoos on halb.
○ Diagnostika ja ravi
Ekseemi kahjustuste (nt atoopiline dermatiit) valediagnoosimine ja steroidsalvi kasutamine süvendab kahjustusi. Antibiootilise salvi manustamise ajal pöörduge arsti poole niipea kui võimalik.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)