Difference between revisions of "Staphylococcal scalded skin syndrome"

(Text replacement - "*CXR" to "*CXR")
(Text replacement - "OR" to "'''OR'''")
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*Often requires inpatient therapy, [[Fluid Resuscitation]], parenteral [[antibiotics]]
 
*Often requires inpatient therapy, [[Fluid Resuscitation]], parenteral [[antibiotics]]
 
===[[Antibiotic]] Options===
 
===[[Antibiotic]] Options===
*[[Nafcillin]] 100mg/kg/d IV in 4 divided doses OR 50mg/kg/d in 4 divided doses PO x7-10d
+
*[[Nafcillin]] 100mg/kg/d IV in 4 divided doses '''OR''' 50mg/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)
 
*[[Penicillin G Procaine]] (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg)
 
*[[Amoxicillin/Clavulanate]] 45mg/kg/d PO in 2 divided doses x 7-10d
 
*[[Amoxicillin/Clavulanate]] 45mg/kg/d PO in 2 divided doses x 7-10d

Revision as of 02:24, 31 May 2017

Background

  • Caused by Staph aureus
  • Most patients <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

Erythematous rash

Evaluation[1]

  • PCR for toxin if available
  • CBC - leukocytosis, though normal WBC level oftenly
  • ESR elevation
  • Monitor electrolytes, renal function closely in severe disease
  • Blood cultures variably positive (more often pos in adults)
  • CXR to rule out pneumonia

Management

Antibiotic Options

Disposition

  • Transfer to burn center if diffuse
  • Localized infection may discharge home with follow up

See Also

References

  1. Randall WK et al. Staphylococcal Scalded Skin Syndrome Workup. eMedicine. Oct 28, 2015. http://emedicine.medscape.com/article/788199-workup.