Staphylococcal Scalded Skin Syndrome - Symptoms and Treatment

Staphylococcal scalded skin syndrome is a syndrome of acute exfoliation of the skin following an erythematous cellulitis. Staphylococcal Scalded Skin Syndrome is caused by the release of two exotoxins from toxigenic strains of the bacteria Staphylococcus aureus. Staphylococcal scalded skin syndrome is a disease, caused by a type of bacteria, in which large sheets of skin may peel away. Staphylococcal scalded skin syndrome occurs almost exclusively in infants, young children, and people with a weakened immune system. Staphylococcal scalded skin syndrome is an illness characterised by red blistering skin that looks like a burn or scald, hence its name staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome is a response to a staphylococcal infection and is characterized by peeling skin.The disease mostly affects infants, young children, and persons with a depressed immune system. Staphylococcal scalded skin syndrome almost always affects children < 6 yr ; it rarely occurs in older patients unless they have renal failure or are immunocompromised. Epidemics may occur in nurseries, presumably transmitted by the hands of personnel in contact with an infected infant or who are nasal carriers of S. aureus . Sporadic cases also occur. On the other hand, exfoliatins may also affect Desmoglein 1, provoking the loss of cellular adhesion. Severity ranges from a localized form, bullous impetigo, to a generalized form with extensive epidermolysis and desquamation. A review of the literature failed to disclose descriptions of staphylococcal scalded skin syndrome as such a complication.

Staphylococcal scalded-skin syndrome is a toxin-mediated epidermolytic disease characterized by erythema, widespread detachment of the superficial layers of the epidermis, resembling scalding, and occurring mainly in newborns and infants younger than 2 years. Staphylococcal Scalded Skin Syndrome primarily strikes children under the age of five, particularly infants. This disease follows a consistent pattern of progression, and most patients recover fully. In Staphylococcal scalded skin syndrome, skin becomes sensitive and uncomfortable even before the rash is fully visible. Staphylococcal scalded skin syndrome is a response to a staphylococcal infection caused by a type of bacteria and characterized by peeling skin in which large sheets of skin may peel away. Careful preoperative and postoperative screening and guidance are urged to prevent staphylococcal scalded skin syndrome and other complications. Mortality is 2% to 3%, with death usually resulting from complications of fluid and electrolyte loss, sepsis, and involvement of other body systems. Staphylococcal scalded skin syndrome occurs almost exclusively in infants, young children, and people with a weakened immune system. Like other staphylococcal infections, staphylococcal scalded skin syndrome is contagious. he disease mostly affects infants, young children, and individuals with a depressed immune system or renal insufficiency. The carrier sites are usually the nostrils and fexures, where the bacteria may be found intermittently or every time they are looked for. Staphylococcal Scalded Skin Syndrome also is known as Ritter von Ritterschein disease in newborns, Ritter disease, Lyell disease, and staphylococcal epidermal necrolysis.

Causes of Staphylococcal Scalded Skin Syndrome

Common Causes and Risk factors of Staphylococcal Scalded Skin Syndrome :

• Alcoholism.
• Staphylococcus family.
• Malnutrition.
• Intravenous drug users.
• Severe atopic dermatitis.
• During the infection.
• Low serum iron.
• Poorly controlled diabetes.

Symptoms of Staphylococcal Scalded Skin Syndrome

Some common Symptoms of Staphylococcal Scalded Skin Syndrome :

• Fever.
• Weakness.
• Blistering.
• Fluid loss.
• Chills.
• Red, painful areas around infection site.
• Crusted infection site, often around the nose or ears.

Treatment of Staphylococcal Scalded Skin Syndrome

Some common Treatment of Staphylococcal Scalded Skin Syndrome :

• Steroids are not indicated at this time.
• Topical wound care should begin with saline, followed by topical antibiotic ointment.
• Patients need fluid rehydration, topical wound care similar to the care for thermal burns, and parenteral antibiotics to cover S aureus .
• Cultures from the exfoliated sites as well as nose, throat, and other potential sites of the original focus of infection should be performed.
• Consideration must be given for the sharply increasing rates of community-acquired S aureus infection (CA-MRSA).
• A chest radiograph should be considered to rule out pneumonia as the original focus of infection.
• The major focus of ED care should be to identify staphylococcal scalded skin syndrome (SSSS) and to stabilize the patient's condition.
• Fluid rehydration is initiated with Lactated Ringer solution at 20 cc/kg initial bolus. Repeat the initial bolus as clinically indicated followed by maintenance therapy with consideration for fluid losses from exfoliation of skin being similar to a burn patient.

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