Staphylococcal scalded skin syndrome: Difference between revisions
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*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 | ||
*No mucous membrane involvement (differentiate from [[SJS]]) | *No mucous membrane involvement (differentiate from [[SJS]]/TENS) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 02:08, 21 February 2016
Background
- Caused by Staph aureus
- Most pts <2yr old, nearly all <6 yr old
Clinical Features
- 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
- No mucous membrane involvement (differentiate from SJS/TENS)
Differential Diagnosis
Diagnosis
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