Staphylococcal scalded skin syndrome - Стафилококковый Синдром Ошпаренной Кожи
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Младенец с Стафилококковый Синдром Ошпаренной Кожи (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome — это состояние, при котором кожа линяет из-за токсинов, вырабатываемых определенными типами бактерий стафилококка. У детей старше шести лет это редкость. Это также может произойти у взрослых с ослабленной иммунной системой или серьезными проблемами с почками. Основной особенностью является обширное шелушение кожи после воспаления. Тяжесть варьируется от нескольких волдырей до обширного поражения кожи, которое может вызвать резкое падение температуры тела и нестабильность кровяного давления.
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-месячный мальчик пришел с насморком и плохо ел. Врачи сказали, что это инфекция верхних дыхательных путей. Через два дня он вернулся, потому что ему не становилось лучше, и у него появились новые проблемы, такие как опухшее лицо и раздражение кожи вокруг рта. В течение следующих двух дней мальчику стало хуже. Его руки и ноги опухли, и кожа начала сходить. Вернувшись в больницу, врачи заметили на его лице и в складках кожи красную сыпь, которая бледнела при прикосновении. Ему поставили диагноз staphylococcal scalded skin syndrome (SSSS) и начали давать антибиотики внутривенно.
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.
Двухлетняя девочка пришла с сыпью по всему телу, которая появилась в течение 48 часов после укусов насекомых на лице накануне. При осмотре у нее была обнаружена обширная сыпь, состоящая из небольших сливающихся друг с другом бугорков, а при легком растирании на коже появились признаки симптома Никольского. Признаков сыпи на слизистых оболочках не было. Анализы ее крови не выявили никаких признаков инфекции.
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 индуцируется эпидермолитическим экзотоксином (эксфолиатином) А и В, выделяемым S. aureus. Прогноз стафилококковый синдром ошпаренной кожи (staphylococcal scalded skin syndrome) у детей отличный, с полным разрешением в течение 10 дней лечения и без значительных рубцов. Однако стафилококковый синдром ошпаренной кожи (staphylococcal scalded skin syndrome) необходимо тщательно дифференцировать от токсического эпидермального некролиза, который имеет плохой прогноз.
○ Диагностика и лечение
Ошибочный диагноз экземы, такой как атопический дерматит, и применение стероидной мази усугубляют поражения. При нанесении мази с антибиотиком как можно скорее обратитесь за медицинской помощью.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)