Staphylococcal scalded skin syndrome: Difference between revisions
No edit summary |
|||
| Line 4: | Line 4: | ||
==Diagnosis== | ==Diagnosis== | ||
*Rash progresses from erythroderma to extensive areas of exfoliation | *[[Rash]] progresses from erythroderma to extensive areas of exfoliation | ||
*Systemic symptoms (malaise, fever, irritability, skin tenderness) are common | *Systemic symptoms (malaise, fever, irritability, skin tenderness) are common | ||
*Nikolsky sign (separation of epidermis when pressure is applied) is present | *Nikolsky sign (separation of epidermis when pressure is applied) is present | ||
| Line 11: | Line 11: | ||
*Often requires inpatient therapy, [[Fluid Resuscitation]], parenteral [[antibiotics]] | *Often requires inpatient therapy, [[Fluid Resuscitation]], parenteral [[antibiotics]] | ||
*[[Antibiotics]] | *[[Antibiotics]] | ||
**Nafcillin 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d | **[[Nafcillin]] 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d | ||
**Penicillin G | **[[Penicillin G Procaine]] (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg) | ||
**Amoxicillin | **[[Amoxicillin/Clavulanate]] 45 mg/kg/d PO in 2 divided doses x 7-10d | ||
**Cefazolin 100 mg/kg/d IV in 4 divided doses | **[[Cefazolin]] 100 mg/kg/d IV in 4 divided doses | ||
**[[Cephalexin]] 40 mg/kg/d in 4 divided doses x 7-10d | **[[Cephalexin]] 40 mg/kg/d in 4 divided doses x 7-10d | ||
**If possible MRSA: | **If possible [[MRSA]]: | ||
***Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d | ***[[Clindamycin]] 40mg/kg/d IV or PO in 4 divided doses x7-10d | ||
***[[Bactrim]] 10 mg/kg/d in 2 divided doses x7-10d | ***[[Bactrim]] 10 mg/kg/d in 2 divided doses x7-10d | ||
***[[Vancomycin]] 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr | ***[[Vancomycin]] 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr | ||
Revision as of 04:49, 22 April 2014
Background
- Caused by Staph aureus
- Most pts <2yr old, nearly all <6 yr old
Diagnosis
- Rash progresses from erythroderma to extensive areas of exfoliation
- Systemic symptoms (malaise, fever, irritability, skin tenderness) are common
- Nikolsky sign (separation of epidermis when pressure is applied) is present
Treatment
- Often requires inpatient therapy, Fluid Resuscitation, parenteral antibiotics
- Antibiotics
- Nafcillin 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d
- Penicillin G Procaine (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg)
- Amoxicillin/Clavulanate 45 mg/kg/d PO in 2 divided doses x 7-10d
- Cefazolin 100 mg/kg/d IV in 4 divided doses
- Cephalexin 40 mg/kg/d in 4 divided doses x 7-10d
- If possible MRSA:
- Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d
- Bactrim 10 mg/kg/d in 2 divided doses x7-10d
- Vancomycin 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr
Disposition
- Transfer to burn center if diffuse
- Localized infection may d/c home w/ f/u
See Also
Source
Tintinalli