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Staphylococcal Scalded Skin Syndrome, Emergency Medicine

Roger M. Barkin Reviewed 06/2017
 


Basics

Description

  • Results from the actions of a soluble epidermolytic exotoxin produced by Staphylococcus aureus:

    • Produced at a distant site of infection or colonization

    • Disseminates hematogenously

    • Lyses...

Diagnosis

Signs and Symptoms

  • Constitutional symptoms:

    • Malaise

    • Fever

    • Irritability

    • Child may appear well, ill, or overtly toxic

    • Abrupt onset

  • Scarlatiniform erythematous rash (sandpaper like) resembling a “sunb...

Treatment

Pre-Hospital

  • 9% NS fluid bolus if dehydration present

  • Initial burn treatment

Initial Stabilization/Therapy

  • Management is similar to an extensive 2nd-degree burn:

    • Involvement of large body surface...

Follow-Up

Disposition

Admission Criteria

  • Children <1 yr

  • All toxic-appearing children

  • Widespread skin involvement

  • Dehydration and/or electrolyte derangement

Discharge Criteria

  • Older, well-appearing childre...

Additional Reading

  • Blyth  M, Estela  C, Young  AE. Severe staphylococcal scalded skin syndrome in children. Burns.  2008;34:98–103.

  • Freedberg  IM, Eisen  AZ, Wolff  K, et al. Fitzpatrick's Dermato...

Codes

ICD9

695.81 Ritter's disease 

ICD10

L00 Staphylococcal scalded skin syndrome 

SNOMED

  • 200946001 Staphylococcal scalded skin syndrome (disorder)

  • 402967005 Neonatal staphylococcal scalded skin syndrome (...

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