Staphylococcal scalded skin syndrome - Syndrome Cutané Échaudé À Staphylocoques
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Un nourrisson avec Syndrome Cutané Échaudé À Staphylocoques (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome est une condition dans laquelle la peau mue en raison de toxines produites par certains types de bactéries Staphylococcus. C'est rare chez les enfants de plus de six ans. Cela peut également survenir chez les adultes dont le système immunitaire est affaibli ou qui ont de graves problèmes rénaux. La principale caractéristique est une desquamation cutanée étendue suite à une inflammation. La gravité varie de quelques cloques à une perte cutanée généralisée, qui peut entraîner de graves baisses de la température corporelle et une instabilité de la pression artérielle.
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.
Un garçon de 10 mois est arrivé avec le nez qui coule et il ne mangeait pas bien. Les médecins ont dit qu'il s'agissait d'une infection des voies respiratoires supérieures. Deux jours plus tard, il est revenu parce que son état ne s'améliorait pas et qu'il avait de nouveaux problèmes comme un visage enflé et une peau irritée autour de la bouche. Au cours des deux jours suivants, l'état de l'enfant s'est aggravé. Ses bras et ses jambes ont enflé et sa peau a commencé à se décoller. De retour à l'hôpital, les médecins ont remarqué une éruption cutanée rouge sur son visage et dans les plis de sa peau, qui blanchissait au toucher. Ils lui ont diagnostiqué staphylococcal scalded skin syndrome (SSSS) et lui ont administré des antibiotiques par voie intraveineuse.
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.
Une fillette de 2 ans s'est présentée avec une éruption cutanée sur tout le corps, apparue en 48 heures, suite à des piqûres d'insectes sur le visage la veille. Lors de l'examen, elle présentait une éruption cutanée généralisée composée de petites bosses qui fusionnaient et, lorsqu'elle était légèrement frottée, sa peau présentait des signes du signe Nikolsky. Il n’y avait aucun signe d’éruption cutanée affectant ses muqueuses. Les analyses de sang n’ont montré aucun signe d’infection.
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.
Le syndrome est induit par les exotoxines épidermolytiques (exfoliatine) A et B, libérées par S. aureus. Le pronostic du syndrome cutané échaudé à staphylocoques (staphylococcal scalded skin syndrome) chez les enfants est excellent, avec une résolution complète dans les 10 jours suivant le traitement et sans cicatrice significative. Cependant, le syndrome cutané échaudé à staphylocoques (staphylococcal scalded skin syndrome) doit être soigneusement différencié de la nécrolyse épidermique toxique, dont le pronostic est sombre.
○ Diagnostic et traitement
Un diagnostic erroné comme des lésions d'eczéma telles que la dermatite atopique et l'application d'une pommade stéroïde exacerbent les lésions. Veuillez consulter un médecin dès que possible lors de l'application d'une pommade antibiotique.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)