Staphylococcal scalded skin syndrome - Stafilokokų Nuplikytos Odos Sindromas
☆ 2022 m. Stiftung Warentest iš Vokietijos rezultatai rodo, kad vartotojų pasitenkinimas ModelDerm buvo tik šiek tiek mažesnis nei mokamų nuotolinės medicinos konsultacijų.
Kūdikis su Stafilokokų Nuplikytos Odos Sindromas (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome yra būklė, kai oda pleiskanoja dėl toksinų, kuriuos gamina tam tikros rūšies Staphylococcus bakterijos. Tai nedažna vyresniems nei šešerių metų vaikams. Tai taip pat gali pasireikšti suaugusiems, kurių imuninė sistema susilpnėjusi arba turintiems rimtų inkstų problemų. Pagrindinis bruožas yra didelis odos lupimasis po uždegimo. Sunkumas svyruoja nuo kelių pūslių iki plačiai paplitusio odos praradimo, dėl kurio gali smarkiai nukristi kūno temperatūra ir nestabilus kraujospūdis.
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 mėnesių berniukas atėjo su sloga ir prastai maitinasi. Gydytojai sakė, kad tai viršutinių kvėpavimo takų infekcija. Po dviejų dienų jis grįžo, nes nepagerėjo ir turėjo naujų problemų, pavyzdžiui, patinęs veidas ir sudirgusi oda aplink burną. Per kitas dvi dienas berniuko būklė pablogėjo. Jo rankos ir kojos ištino, o oda pradėjo slinkti. Grįžę į ligoninę gydytojai pastebėjo raudoną bėrimą ant veido ir odos raukšlių, kurie palietus blyškėjo. Jie diagnozavo jam staphylococcal scalded skin syndrome (SSSS) ir pradėjo vartoti antibiotikus per veną.
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 metų mergaitei po vabzdžių įkandimų veidą prieš dieną atsirado bėrimas visame kūne, kuris išsivystė per 48 valandas. Apžiūros metu jai buvo išplitęs bėrimas, sudarytas iš mažų gumbelių, kurie susiliejo, o švelniai patrynus jos odoje atsirado Nikolskio ženklo požymių. Jokių požymių, kad bėrimas paveikė jos gleivinę, nebuvo. Jos kraujo tyrimai nerodė jokių infekcijos požymių.
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.
Sindromą sukelia epidermolitiniai egzotoksinai (eksfoliatinas)A ir B, kuriuos išskiria S. aureus. Vaikų stafilokokų nuplikytos odos sindromas (staphylococcal scalded skin syndrome) prognozė yra puiki, ji visiškai išnyksta per 10 dienų nuo gydymo ir be didelių randų. Tačiau stafilokokų nuplikytos odos sindromas (staphylococcal scalded skin syndrome) turi būti kruopščiai atskirtas nuo toksinės epidermio nekrolizės, kurios prognozė yra prasta.
○ Diagnostika ir gydymas
Klaidinga diagnozė kaip egzemos pažeidimai, pvz., atopinis dermatitas, ir steroidinio tepalo naudojimas pablogina pažeidimus. Naudojant antibiotikų tepalą, kuo greičiau kreipkitės medicininės pagalbos.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)