Staphylococcal scalded skin syndrome
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Dojenček z Staphylococcal scalded skin syndrome
References
Staphylococcal Scalded Skin Syndrome je stanje, pri katerem se koža lušči zaradi toksinov, ki jih proizvajajo nekatere vrste bakterij Staphylococcus. Pri otrocih, starejših od šest let, je redka. Pojavi se lahko tudi pri odraslih z oslabljenim imunskim sistemom ali resnimi težavami z ledvicami. Glavna značilnost je obsežno luščenje kože po vnetju. Resnost sega od nekaj mehurčkov do razširjene izgube kože, ki lahko povzroči hude padce telesne temperature in nestabilnost krvnega tlaka.
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.
Prišel je 10-mesečni fantek z izcedkom iz nosu in slabo jedel. Zdravniki so rekli, da gre za okužbo zgornjih dihal. Čez dva dni se je vrnil, ker mu ni bilo bolje in imel je nove težave, kot sta otekel obraz in razdražena koža okrog ust. V naslednjih dveh dneh se je dečku poslabšalo. Njegove roke in noge so otekle in koža se mu je začela odlepiti. V bolnišnici so zdravniki opazili rdeč izpuščaj na njegovem obrazu in v kožnih gubah, ki je ob dotiku zbledel. Postavili so mu diagnozo staphylococcal scalded skin syndrome (SSSS) in mu dali antibiotike skozi veno.
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-letna deklica se je pojavila z izpuščajem po celem telesu, ki se je razvil v 48 urah po pikih žuželk na njenem obrazu dan prej. Med pregledom je imela razširjen izpuščaj, sestavljen iz majhnih izboklin, ki so se zlile skupaj, in ob rahlem drgnjenju je njena koža kazala znake Nikolskega. Ni bilo znakov, da bi izpuščaj vplival na njene sluznice. Testi njene krvi niso pokazali nobenih znakov okužbe.
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 povzročata epidermolitična eksotoksina (eksfoliatin)A in B, ki ju sprošča S. aureus. Napoved staphylococcal scalded skin syndrome pri otrocih je odlična, s popolno ozdravitvijo v 10 dneh po zdravljenju in brez pomembnih brazgotin. Vendar je treba staphylococcal scalded skin syndrome skrbno razlikovati od toksične epidermalne nekrolize, ki ima slabo prognozo.
○ Diagnoza in zdravljenje
Napačna diagnoza kot lezije ekcema, kot je atopični dermatitis, in uporaba steroidnega mazila poslabša lezije. Med nanašanjem antibiotičnega mazila čim prej poiščite zdravniško pomoč.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)