Staphylococcal scalded skin syndrome
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Isang sanggol na may Staphylococcal scalded skin syndrome
References
Ang Staphylococcal Scalded Skin Syndrome ay isang kondisyon kung saan ang balat ay nalaglag dahil sa mga lason na ginawa ng ilang uri ng Staphylococcus bacteria. Ito ay bihira sa mga batang mahigit anim. Maaari rin itong mangyari sa mga nasa hustong gulang na may mahinang immune system o malubhang problema sa bato. Ang pangunahing tampok ay ang malawak na pagbabalat ng balat kasunod ng pamamaga. Ang kalubhaan ay mula sa ilang paltos hanggang sa malawakang pagkawala ng balat, na maaaring magdulot ng matinding pagbaba sa temperatura ng katawan at kawalang-tatag sa presyon ng dugo.
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.
Isang 10-buwang gulang na batang lalaki ang pumasok na sipon ang ilong at hindi kumakain ng maayos. Sinabi ng mga doktor na ito ay isang upper respiratory infection. Pagkalipas ng dalawang araw, bumalik siya dahil hindi na siya gumagaling at nagkaroon ng mga bagong problema tulad ng namamagang mukha at nanggagalaiti na balat sa paligid ng bibig. Sa sumunod na dalawang araw, lumala ang bata. Ang kanyang mga braso at binti ay namamaga at ang kanyang balat ay nagsimulang matanggal. Pagbalik sa ospital, napansin ng mga doktor ang isang pulang pantal sa kanyang mukha at sa mga tupi ng kanyang balat, na namumula kapag hinawakan. Na-diagnose nila siya ng staphylococcal scalded skin syndrome (SSSS) at sinimulan siya sa mga antibiotic sa pamamagitan ng ugat.
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.
Isang 2-taong-gulang na batang babae ang nagpakita na may pantal sa buong katawan niya na nabuo sa loob ng 48 oras, kasunod ng mga kagat ng insekto sa kanyang mukha noong nakaraang araw. Sa panahon ng pagsusuri, nagkaroon siya ng malawakang pantal na binubuo ng maliliit na bukol na nagsanib-sanib, at kapag bahagyang kinuskos, ang kanyang balat ay nagpakita ng mga palatandaan ng Nikolsky sign. Walang mga palatandaan ng pantal na nakakaapekto sa kanyang mauhog na lamad. Ang mga pagsusuri sa kanyang dugo ay hindi nagpakita ng anumang senyales ng impeksyon.
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.
Ang sindrom ay sapilitan ng epidermolytic exotoxins (exfoliatin) A at B, na inilabas ng S. aureus. Ang pagbabala ng staphylococcal scalded skin syndrome sa mga bata ay mahusay, na may kumpletong resolusyon sa loob ng 10 araw ng paggamot, at walang makabuluhang pagkakapilat. Gayunpaman, ang staphylococcal scalded skin syndrome ay dapat na maingat na pag-iba-iba mula sa nakakalason na epidermal necrolysis, na nagdadala ng hindi magandang prognosis.
○ Diagnosis at Paggamot
Ang maling pagsusuri bilang mga sugat sa eksema tulad ng atopic dermatitis, at paglalagay ng steroid ointment ay nagpapalala ng mga sugat. Mangyaring humingi ng medikal na atensyon sa lalong madaling panahon habang naglalagay ng antibiotic ointment.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)