Staphylococcal scalded skin syndrome - Staphylococcal Scalded Skin Syndrom
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Et spedbarn med Staphylococcal Scalded Skin Syndrom (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome er en tilstand der huden faller på grunn av giftstoffer produsert av visse typer stafylokokkbakterier. Det er uvanlig hos barn over seks år. Det kan også forekomme hos voksne med svekket immunforsvar eller alvorlige nyreproblemer. Hovedtrekket er omfattende hudpeeling etter betennelse. Alvorlighetsgraden varierer fra noen få blemmer til utbredt hudtap, som kan forårsake alvorlige fall i kroppstemperatur og ustabilitet i blodtrykket.
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.
En 10 måneder gammel gutt kom inn med rennende nese og spiste dårlig. Legene sa at det var en øvre luftveisinfeksjon. To dager senere kom han tilbake fordi han ikke ble bedre og hadde nye problemer som hovent ansikt og irritert hud rundt munnen. I løpet av de neste to dagene ble gutten verre. Armene og bena hans hovnet opp og huden begynte å løsne. Tilbake på sykehuset la legene merke til et rødt utslett i ansiktet og i hudfoldene, som ble blanchert ved berøring. De diagnostiserte ham med staphylococcal scalded skin syndrome (SSSS) og startet ham på antibiotika gjennom en blodåre.
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.
En 2 år gammel jente dukket opp med utslett over hele kroppen som hadde utviklet seg over 48 timer, etter insektbitt i ansiktet dagen før. Under undersøkelsen hadde hun et utbredt utslett bestående av små nupper som smeltet sammen, og når hun ble gnidd lett, viste huden hennes tegn til Nikolsky-tegn. Det var ingen tegn til at utslettet påvirket slimhinnene hennes. Blodet hennes viste ingen tegn på infeksjon.
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.
Syndromet induseres av epidermolytiske eksotoksiner (exfoliatin)A og B, som frigjøres av S. aureus. Prognosen for staphylococcal scalded skin syndrom (staphylococcal scalded skin syndrome) hos barn er utmerket, med fullstendig oppløsning innen 10 dager etter behandling, og uten signifikant arrdannelse. staphylococcal scalded skin syndrom (staphylococcal scalded skin syndrome) må imidlertid skilles nøye fra toksisk epidermal nekrolyse, som har dårlig prognose.
○ Diagnose og behandling
Feildiagnostisering som eksemlesjoner som atopisk dermatitt og påføring av steroidsalve forverrer lesjonene. Vennligst oppsøk lege så snart som mulig mens du påfører antibiotisk salve.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)