Staphylococcal scalded skin syndrome - Stafilokoku Mērogots Ādas Sindroms
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Zīdainis ar Stafilokoku Mērogots Ādas Sindroms (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome ir stāvoklis, kad āda izdalās dažu veidu Staphylococcus baktēriju radīto toksīnu dēļ. Tas ir retāk sastopams bērniem, kas vecāki par sešiem gadiem. Tas var rasties arī pieaugušajiem ar novājinātu imūnsistēmu vai nopietnām nieru problēmām. Galvenā iezīme ir plaša ādas lobīšanās pēc iekaisuma. Smaguma pakāpe svārstās no dažiem tulzniem līdz plaši izplatītam ādas zudumam, kas var izraisīt smagu ķermeņa temperatūras pazemināšanos un asinsspiediena nestabilitāti.
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.
Ienāca 10 mēnešus vecs zēns ar iesnām un slikti ēd. Ārsti teica, ka tā ir augšējo elpceļu infekcija. Pēc divām dienām viņš atgriezās, jo nepalika labāk, un viņam bija jaunas problēmas, piemēram, pietūkusi seja un kairināta āda ap muti. Nākamo divu dienu laikā zēnam kļuva sliktāk. Viņa rokas un kājas pietūka, un viņa āda sāka atdalīties. Atgriežoties slimnīcā, ārsti pamanīja sarkanus izsitumus uz viņa sejas un ādas krokās, kas, pieskaroties, blanšēja. Viņi viņam diagnosticēja staphylococcal scalded skin syndrome (SSSS) un sāka lietot antibiotikas caur vēnu.
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 gadus veca meitene parādījās ar izsitumiem visā ķermenī, kas bija attīstījušies 48 stundu laikā pēc kukaiņu kodumiem viņas sejā iepriekšējā dienā. Pārbaudes laikā viņai bija plaši izsitumi, kas sastāvēja no maziem izciļņiem, kas saplūda kopā, un, viegli berzējot, uz ādas bija redzamas Nikoļska zīmes pazīmes. Nebija nekādu izsitumu pazīmju, kas būtu ietekmējušas viņas gļotādu. Viņas asins analīzes neuzrādīja nekādas infekcijas pazīmes.
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.
Sindromu izraisa epidermolītiskie eksotoksīni (eksfoliatīns) A un B, ko izdala S. aureus. stafilokoku mērogots ādas sindroms (staphylococcal scalded skin syndrome) prognoze bērniem ir lieliska, pilnībā izzūd 10 dienu laikā pēc ārstēšanas un bez ievērojamām rētām. Tomēr stafilokoku mērogots ādas sindroms (staphylococcal scalded skin syndrome) ir rūpīgi jānošķir no toksiskās epidermas nekrolīzes, kurai ir slikta prognoze.
○ Diagnostika un ārstēšana
Nepareiza diagnoze kā ekzēmas bojājumi, piemēram, atopiskais dermatīts, un steroīdu ziedes lietošana pastiprina bojājumus. Antibiotiku ziedes lietošanas laikā pēc iespējas ātrāk meklējiet medicīnisko palīdzību.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)