Staphylococcal scalded skin syndrome - Stafýlókokka Sviðað Húðheilkenni
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Ungbarn með Stafýlókokka Sviðað Húðheilkenni (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome er ástand þar sem húðin losnar vegna eiturefna sem framleidd eru af ákveðnum tegundum Staphylococcus baktería. Það er sjaldgæft hjá börnum eldri en sex ára. Það getur einnig komið fram hjá fullorðnum með veikt ónæmiskerfi eða alvarlega nýrnavandamál. Aðaleiginleikinn er mikil húðflögnun í kjölfar bólgu. Alvarleiki er allt frá nokkrum blöðrum til útbreiddrar húðmissis, sem getur valdið alvarlegum lækkunum á líkamshita og óstöðugleika í blóðþrýstingi.
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 mánaða drengur kom inn með nefrennsli og borðaði illa. Læknar sögðu að þetta væri sýking í efri öndunarvegi. Tveimur dögum síðar kom hann aftur vegna þess að hann var ekki að batna og fékk ný vandamál eins og bólgið andlit og pirraða húð í kringum munninn. Næstu tvo daga versnaði drengnum. Handleggir hans og fætur bólgnuðu upp og húð hans fór að losna. Aftur á spítalanum tóku læknarnir eftir rauðum útbrotum í andliti hans og í húðfellingum hans, sem bleiknaði við snertingu. Þeir greindu hann með staphylococcal scalded skin syndrome (SSSS) og tóku hann á sýklalyf í gegnum æð.
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.
Tveggja ára stúlka kom fram með útbrot um allan líkamann sem höfðu þróast í rúmar 48 klukkustundir, eftir skordýrabit í andliti hennar daginn áður. Við skoðun var hún með útbreidd útbrot sem samanstóð af litlum hnúðum sem runnu saman og þegar hún var nudd létt sýndi húð hennar merki Nikolsky merkisins. Engin merki voru um að útbrotin hefðu áhrif á slímhúð hennar. Prófanir á blóði hennar sýndu engin merki um sýkingu.
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.
Heilkennið er framkallað af epidermolytic exotoxin (exfoliatin)A og B, sem eru losuð af S. aureus. Horfur á stafýlókokka sviðað húðheilkenni (staphylococcal scalded skin syndrome) hjá börnum eru frábærar, leysist að fullu innan 10 daga frá meðferð og án teljandi öra. Hins vegar verður að greina stafýlókokka sviðað húðheilkenni (staphylococcal scalded skin syndrome) vandlega frá eitruðum húðþekjudrepi, sem hefur slæmar horfur.
○ Greining og meðferð
Ranggreining sem exemskemmdir eins og ofnæmishúðbólga og notkun á sterasmyrsli eykur sár. Vinsamlegast leitaðu til læknis eins fljótt og auðið er á meðan þú notar sýklalyfjasmyrsl.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)