Staphylococcal scalded skin syndrome - Stafilokokal Ölçekli Cilt Sendromu
☆ Almanya'daki 2022 Stiftung Warentest sonuçlarında ModelDerm'den tüketici memnuniyeti, ücretli teletıp danışmanlıklarından yalnızca biraz daha düşüktü.
Stafilokokal Ölçekli Cilt Sendromu (Staphylococcal scalded skin syndrome) olan bir bebek
References
Staphylococcal Scalded Skin Syndrome Stafilokok bakterilerinin belirli türlerinin ürettiği toksinler nedeniyle cildin döküldüğü bir durumdur. Altı yaş üstü çocuklarda nadirdir. Ayrıca bağışıklık sistemi zayıf olan veya ciddi böbrek sorunları olan yetişkinlerde de ortaya çıkabilir. Başlıca özelliği iltihaplanmayı takiben derinin geniş çapta soyulmasıdır. Şiddeti birkaç kabarcıktan, vücut ısısında ciddi düşüşlere ve kan basıncında dengesizliğe neden olabilecek yaygın cilt kaybına kadar değişir.
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 aylık bir erkek çocuk burun akıntısı ve iyi yemek yememe şikâyetiyle geldi. Doktorlar üst solunum yolu enfeksiyonu olduğunu söyledi. İki gün sonra, iyileşmediği ve yüzün şişmesi ve ağız çevresindeki cildin tahriş olması gibi yeni sorunları olduğu için geri geldi. Sonraki iki gün içinde çocuk daha da kötüleşti. Kolları ve bacakları şişti ve derisi soyulmaya başladı. Hastaneye döndüğünde doktorlar yüzünde ve derisinin kıvrımlarında dokunulduğunda beyazlaşan kırmızı bir döküntü fark ettiler. Ona staphylococcal scalded skin syndrome (SSSS) teşhisi koydular ve damar yoluyla antibiyotik tedavisine başladılar.
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 yaşında bir kız çocuğu, önceki gün yüzündeki böcek ısırıklarının ardından 48 saat içinde vücudunun her yerinde gelişen döküntülerle ortaya çıktı. Muayene sırasında, birbirine karışan küçük şişliklerden oluşan yaygın bir döküntüsü vardı ve hafifçe ovalandığında cildinde Nikolsky belirtisi belirtileri görülüyordu. Mukoza zarlarını etkileyen herhangi bir döküntü belirtisi yoktu. Kanında yapılan testlerde herhangi bir enfeksiyon belirtisi görülmedi.
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.
Sendrom, S. aureus tarafından salınan epidermolitik ekzotoksinler (eksfoliatin)A ve B tarafından indüklenir. Çocuklarda stafilokokal ölçekli cilt sendromu (staphylococcal scalded skin syndrome) 'un prognozu mükemmeldir, tedaviden sonraki 10 gün içinde tamamen düzelir ve belirgin bir yara izi kalmaz. Ancak stafilokokal ölçekli cilt sendromu (staphylococcal scalded skin syndrome) kötü prognozlu toksik epidermal nekrolizden dikkatli bir şekilde ayrılmalıdır.
○ Teşhis ve tedavi
Atopik dermatit gibi egzama lezyonlarının yanlış tanısı ve steroid merhem uygulanması lezyonları şiddetlendirmektedir. Antibiyotik merhem sürerken lütfen mümkün olan en kısa sürede tıbbi yardım alın.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)