Staphylococcal scalded skin syndrome
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Staphylococcal scalded skin syndrome-тэй нярай
References
Staphylococcal Scalded Skin Syndrome гэдэг нь тодорхой төрлийн стафилококк бактерийн үүсгэсэн хорт бодисоос болж арьс гадагшлах эмгэг юм. Энэ нь зургаагаас дээш насны хүүхдүүдэд ховор тохиолддог. Энэ нь дархлаа суларсан эсвэл бөөрний ноцтой асуудалтай насанд хүрэгчдэд ч тохиолдож болно. Гол онцлог нь үрэвслийн дараа арьс их хэмжээгээр хальслах явдал юм. Хэд хэдэн цэврүүтэхээс эхлээд арьсны өргөн алдагдал хүртэл хэлбэлздэг бөгөөд энэ нь биеийн температур огцом буурч, цусны даралтыг тогтворгүй болгодог.
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 сартай хүү хамар гоожиж, хоол иддэггүй байсан. Эмч нар үүнийг амьсгалын дээд замын халдвар гэж хэлсэн. Хоёр хоногийн дараа бие нь сайжрахгүй, нүүр хавдсан, амны эргэн тойронд арьс цочрох зэрэг шинэ асуудалтай тул буцаж ирсэн. Дараагийн хоёр хоногт хүүгийн байдал улам дордов. Түүний гар, хөл хавдаж, арьс нь салж эхэлсэн. Эмнэлэгт буцаж ирэхэд эмч нар түүний нүүр, арьсны нугалахад улаан тууралт гарч, хүрэх үед цайрсан болохыг анзаарчээ. Тэд түүнийг staphylococcal scalded skin syndrome (SSSS) гэж оношилж, судсаар антибиотик эмчилгээг эхлүүлсэн.
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 настай охин өмнөх өдөр нь нүүрэн дээр нь шавьж хазуулсны дараа 48 цагийн турш үүссэн бүх биеэр тууралт гарч иржээ. Үзлэгийн үеэр түүний арьсанд нийлсэн жижиг овойлтоос бүрдсэн тууралт гарч, бага зэрэг үрэхэд түүний арьсанд Никольскийн шинж тэмдэг илэрчээ. Түүний салст бүрхэвчинд тууралт гарсан шинж тэмдэг илрээгүй. Түүний цусан дахь шинжилгээнд халдварын шинж тэмдэг илрээгүй.
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.
Синдром нь S. aureus-аас ялгардаг эпидермолитик экзотоксин (экзотоксин) А ба В-ээр өдөөгддөг. Хүүхдэд staphylococcal scalded skin syndrome өвчний прогноз маш сайн, эмчилгээ хийснээс хойш 10 хоногийн дотор бүрэн арилдаг бөгөөд мэдэгдэхүйц сорви байхгүй. Гэсэн хэдий ч staphylococcal scalded skin syndrome нь таамаглал муутай эпидермисийн хорт үхжилээс сайтар ялгах ёстой.
○ Оношлогоо, эмчилгээ
Атопик дерматит гэх мэт экземийн гэмтэл гэж буруу оношлох, стероид тос түрхэх нь гэмтлийг улам хүндрүүлдэг. Антибиотик тос түрхэхдээ аль болох хурдан эмчид хандаарай.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)