Staphylococcal scalded skin syndrome - Síndrome De Pel Escaldada Estafilocócica
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Un bebé con Síndrome De Pel Escaldada Estafilocócica (Staphylococcal scalded skin syndrome)
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ReferencesStaphylococcal Scalded Skin Syndrome é unha condición na que a pel se desprende debido ás toxinas producidas por certos tipos de bacterias Staphylococcus. É pouco común en nenos maiores de seis anos. Tamén pode ocorrer en adultos con sistemas inmunitarios debilitados ou problemas renais graves. A principal característica é un extenso descamado da pel despois da inflamación. A gravidade varía dende algunhas bolhas ata unha perda de pel xeneralizada, que pode provocar graves baixadas da temperatura corporal e inestabilidade da presión arterial.
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.
Entrou un neno de 10 meses con secreción nasal e non comendo ben. Os médicos dixeron que era unha infección das vías respiratorias superiores. Dous días despois, volveu porque non estaba a mellorar e tiña novos problemas como a cara inchada e a pel irritada arredor da boca. Durante os dous días seguintes, o neno empeorou. Os seus brazos e as pernas incháronse e a pel comezou a desprenderse. De volta ao hospital, os médicos notaron unha erupción vermella no seu rostro e nos pregamentos da pel, que palidecía ao tocar. Diagnosticáronlle staphylococcal scalded skin syndrome (SSSS) e puxéronlle antibióticos por vena.
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.
Unha nena de 2 anos presentou unha erupción cutánea en todo o corpo que se desenvolveu ao longo de 48 horas, despois das picaduras de insectos na cara o día anterior. Durante o exame, presentou unha erupción xeneralizada composta por pequenas protuberancias que se fusionaban e, ao frotar lixeiramente a pel, aparecía o signo de Nikolsky. Non había lesións da erupción que afectaran as membranas mucosas. As probas sanguíneas non revelaron signos de infección.
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.
A síndrome é inducida por exotoxinas epidermolíticas (exfoliatina) A e B, que son liberadas por S. aureus. O prognóstico do síndrome da pel escaldada estafilocócica (Staphylococcal scalded skin syndrome) en nenos é excelente, con resolución completa aos 10 días de tratamento e sen cicatrices significativas. Porén, o síndrome da pel escaldada estafilocócica (Staphylococcal scalded skin syndrome) debe diferenciarse coidadosamente da necrólise epidérmica tóxica, que ten un prognóstico desfavorable.
○ Diagnóstico e Tratamento
Un diagnóstico erróneo, como confundir a condición con eczema ou dermatite atópica, e a aplicación de ungüentos esteroides, exacerban as lesións. Busque atención médica o antes posible, mentres se aplica un ungüento antibiótico.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)