Staphylococcal scalded skin syndrome - ブドウ球菌性熱傷皮膚症候群
relevance score : -100.0%
ReferencesStaphylococcal Scalded Skin Syndrome は、特定の種類のブドウ球菌が産生する毒素により皮膚が剥がれる状態です。6歳以上の子供ではまれです。また、免疫力が低下していたり、腎臓に重篤な問題がある成人でも発生する可能性があります。主な特徴は、炎症後に皮膚が広範囲に剥離することです。重症度は、数個の水疱から広範囲にわたる皮膚の喪失までさまざまです。これにより、体温が大幅に低下したり、血圧が不安定になったりすることがあります。
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.
生後10か月の男の子が、鼻水を垂らし、食事もうまくいっていない状態で来院しました。医師らは上気道感染症だと述べた。 2日後、彼は症状が改善せず、顔の腫れや口の周りの皮膚の炎症などの新たな問題を抱えて戻ってきた。次の 2 日間で、少年の状態は悪化しました。腕と足が腫れ上がり、皮膚が剥がれ始めました。病院に戻った医師たちは、彼の顔と皮膚のひだに赤い発疹があり、触れると青くなっていることに気づきました。彼らは彼を staphylococcal scalded skin syndrome (SSSS) と診断し、抗生物質の静脈投与を開始しました。
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歳の女の子は、前日に顔を虫に刺された後、48時間以上かけて全身に発疹が出ました。検査時、彼女の皮膚には小さな隆起が合体した広範囲の発疹が認められ、軽くこすったところでニコルスキー徴候が現れました。粘膜に病変は認められませんでした。血液検査でも感染の所見は見られませんでした。
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.
ブドウ球菌性熱傷皮膚症候群 (staphylococcal scalded skin syndrome) では、広範囲に及ぶ疼痛を伴う紅皮症がしばしば見られ、顔やおむつ部位、その他の皮膚間部が侵されます。広範囲の剥離が認められることもあります。初期段階では口周囲にかさぶたや亀裂が出ることがあります。中毒性表皮壊死融解症とは異なり、ブドウ球菌性熱傷皮膚症候群 (staphylococcal scalded skin syndrome) では粘膜は影響を受けません。主に6歳未満の小児に多く見られます。
この症候群は、黄色ブドウ球菌が産生する表皮溶解性外毒素 (エクスフォリアチン) A および B によって引き起こされます。小児におけるブドウ球菌性熱傷皮膚症候群 (staphylococcal scalded skin syndrome) の予後は良好で、治療開始から10日以内に完全に治癒し、重大な瘢痕は残りません。ただし、予後不良の中毒性表皮壊死融解症とは慎重に区別する必要があります。
○ 診断と治療
アトピー性皮膚炎などの湿疹と誤診され、ステロイド軟膏を使用すると症状が悪化することがあります。抗生物質軟膏を使用しつつ、できるだけ早く医師の診察を受けてください。
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)