Staphylococcal scalded skin syndrome - Sindrom Kulit Melecur Staphylococcal
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Bayi dengan Sindrom Kulit Melecur Staphylococcal (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome ialah satu keadaan di mana kulit menumpahkan akibat toksin yang dihasilkan oleh beberapa jenis bakteria Staphylococcus. Ia jarang berlaku pada kanak-kanak berumur lebih dari enam tahun. Ia juga boleh berlaku pada orang dewasa dengan sistem imun yang lemah atau masalah buah pinggang yang serius. Ciri utama adalah pengelupasan kulit yang meluas berikutan keradangan. Keterukan berkisar daripada beberapa lepuh hingga kehilangan kulit yang meluas, yang boleh menyebabkan penurunan suhu badan yang teruk dan ketidakstabilan tekanan darah.
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.
Seorang budak lelaki berusia 10 bulan datang dengan hidung berair dan tidak makan dengan baik. Doktor berkata ia adalah jangkitan saluran pernafasan atas. Dua hari kemudian, dia kembali kerana dia tidak sembuh dan mengalami masalah baru seperti muka bengkak dan kulit yang merengsa di sekitar mulut. Dalam dua hari berikutnya, budak lelaki itu menjadi lebih teruk. Tangan dan kakinya membengkak dan kulitnya mula terkeluar. Sekembalinya ke hospital, doktor mendapati ruam merah pada muka dan lipatan kulitnya, yang pudar apabila disentuh. Mereka mendiagnosisnya dengan staphylococcal scalded skin syndrome (SSSS) dan memulakannya dengan antibiotik melalui urat.
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.
Seorang kanak-kanak perempuan berusia 2 tahun muncul dengan ruam di seluruh badannya yang telah berkembang selama 48 jam, berikutan gigitan serangga di mukanya sehari sebelumnya. Semasa pemeriksaan, dia mengalami ruam yang meluas terdiri daripada benjolan kecil yang bergabung bersama, dan apabila digosok sedikit, kulitnya menunjukkan tanda-tanda Nikolsky. Tiada tanda-tanda ruam menjejaskan selaput lendirnya. Ujian pada darahnya tidak menunjukkan sebarang tanda jangkitan.
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.
Sindrom ini disebabkan oleh eksotoksin epidermolitik (exfoliatin) A dan B, yang dikeluarkan oleh S. aureus. Prognosis sindrom kulit melecur staphylococcal (staphylococcal scalded skin syndrome) pada kanak-kanak adalah sangat baik, dengan resolusi lengkap dalam tempoh 10 hari rawatan, dan tanpa parut yang ketara. Walau bagaimanapun, sindrom kulit melecur staphylococcal (staphylococcal scalded skin syndrome) mesti dibezakan dengan teliti daripada nekrolisis epidermis toksik, yang membawa prognosis yang buruk.
○ Diagnosis dan Rawatan
Kesalahan diagnosis sebagai lesi ekzema seperti dermatitis atopik, dan penggunaan salap steroid memburukkan lagi lesi. Sila dapatkan rawatan perubatan secepat mungkin semasa menggunakan salap antibiotik.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)