Staphylococcal scalded skin syndrome
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Mtoto mchanga mwenye Staphylococcal scalded skin syndrome
References
Staphylococcal Scalded Skin Syndrome ni hali ya ngozi kumwagika kutokana na sumu zinazozalishwa na aina fulani za bakteria wa Staphylococcus. Ni kawaida kwa watoto zaidi ya sita. Inaweza pia kutokea kwa watu wazima walio na kinga dhaifu au matatizo makubwa ya figo. Kipengele kikuu ni ngozi ya ngozi baada ya kuvimba. Ukali ni kati ya malengelenge machache hadi upotezaji mkubwa wa ngozi, ambayo inaweza kusababisha kushuka kwa joto kwa mwili na kukosekana kwa utulivu wa shinikizo la damu.
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.
Mvulana wa miezi 10 aliingia akiwa na pua na hakula vizuri. Madaktari walisema ni maambukizo ya njia ya juu ya kupumua. Siku mbili baadaye, alirudi kwa sababu hakuwa akipata nafuu na alikuwa na matatizo mapya kama uso kuvimba na kuwashwa kwa ngozi mdomoni. Katika siku mbili zilizofuata, mvulana huyo alizidi kuwa mbaya. Mikono na miguu yake ilivimba na ngozi yake ilianza kutoka. Kurudi hospitalini, madaktari waliona upele mwekundu usoni mwake na kwenye mikunjo ya ngozi yake, ambayo ilikuwa na blanch inapoguswa. Walimgundua kuwa na staphylococcal scalded skin syndrome (SSSS) na kumwanzishia dawa za kuua vijasumu kupitia mshipa.
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.
Msichana mwenye umri wa miaka 2 alionekana akiwa na upele mwili mzima ambao ulikuwa umetokea kwa zaidi ya saa 48, kufuatia kuumwa na wadudu usoni siku moja kabla. Wakati wa uchunguzi, alikuwa na upele ulioenea ulioundwa na matuta madogo ambayo yaliunganishwa pamoja, na wakati wa kusugua kidogo, ngozi yake ilionyesha ishara za Nikolsky. Hakukuwa na dalili zozote za upele kuathiri utando wake wa mucous. Vipimo kwenye damu yake havikuonyesha dalili zozote za kuambukizwa.
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.
Ugonjwa huu husababishwa na exotoxins za epidermolytic (exfoliatin)A na B, ambazo hutolewa na S. aureus. Ubashiri wa staphylococcal scalded skin syndrome kwa watoto ni bora, na utatuzi kamili ndani ya siku 10 za matibabu, na bila kovu kubwa. Hata hivyo, staphylococcal scalded skin syndrome lazima itofautishwe kwa uangalifu kutoka kwa necrolysis yenye sumu ya epidermal, ambayo hubeba ubashiri mbaya.
○ Uchunguzi na Tiba
Utambuzi mbaya kama vidonda vya ukurutu kama vile ugonjwa wa ngozi ya atopiki, na utumiaji wa marashi ya steroid huongeza vidonda. Tafadhali tafuta matibabu haraka iwezekanavyo unapopaka mafuta ya antibiotiki.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)