Staphylococcal scalded skin syndrome - Sindromul De Piele Opărită Stafilococică
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Un copil cu Sindromul De Piele Opărită Stafilococică (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome este o afecțiune în care pielea se scurge din cauza toxinelor produse de anumite tipuri de bacterii Staphylococcus. Este mai puțin frecventă la copiii peste șase ani. Poate apărea și la adulții cu sistem imunitar slăbit sau cu probleme grave ale rinichilor. Caracteristica principală este exfolierea extensivă a pielii în urma inflamației. Severitatea variază de la câteva vezicule până la pierderea pe scară largă a pielii, care poate provoca scăderi severe ale temperaturii corpului și instabilitate a tensiunii arteriale.
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.
Un băiețel de 10 luni a intrat cu nasul care curge și nu mânca bine. Medicii au spus că este o infecție a căilor respiratorii superioare. Două zile mai târziu, s-a întors pentru că nu se mai bine și a avut noi probleme precum fața umflată și pielea iritată din jurul gurii. În următoarele două zile, băiatul s-a înrăutățit. Brațele și picioarele i s-au umflat și pielea a început să se desprindă. Înapoi la spital, medicii i-au observat o erupție roșie pe față și în pliurile pielii, care s-a albit la atingere. L-au diagnosticat cu staphylococcal scalded skin syndrome (SSSS) și i-au început să ia antibiotice printr-o venă.
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.
O fetiță de 2 ani a apărut cu o erupție pe tot corpul care s-a dezvoltat în decurs de 48 de ore, în urma mușcăturilor de insecte pe față cu o zi înainte. În timpul examinării, ea a avut o erupție cutanată pe scară largă formată din mici umflături care s-au îmbinat, iar atunci când a fost frecat ușor, pielea ei a arătat semne ale semnului Nikolsky. Nu au existat semne ale erupției cutanate care i-au afectat mucoasele. Testele pe sângele ei nu au arătat niciun semn de infecție.
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.
Sindromul este indus de exotoxinele epidermolitice (exfoliatina) A și B, care sunt eliberate de S. aureus. Prognosticul sindromul de piele opărită stafilococică (staphylococcal scalded skin syndrome) la copii este excelent, cu rezoluție completă în 10 zile de la tratament și fără cicatrici semnificative. Cu toate acestea, sindromul de piele opărită stafilococică (staphylococcal scalded skin syndrome) trebuie diferențiat cu atenție de necroliza epidermică toxică, care are un prognostic prost.
○ Diagnostic și tratament
Diagnosticul greșit ca leziuni de eczemă, cum ar fi dermatita atopică, și aplicarea de unguent cu steroizi exacerba leziunile. Vă rugăm să solicitați asistență medicală cât mai curând posibil în timp ce aplicați unguent antibiotic.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)