Staphylococcal scalded skin syndrome ssss is a serious skin infection caused by the bacterium staphylococcus aureus. Methicillinresistant staphylococcus aureus mrsa mrsa is one of the most common antibioticresistant strain of staph bacteria. Staphylococcal scalded skin syndrome ssss is a toxinmediated systemic illness that is manifested as an epidermal blistering disorder. Increasing numbers of staphylococcal scalded skin syndrome c. Enterotoxins superantigens at least 10 soluble toxins produced by about 50% of s. Staphylococcal scalded skin syndrome definition staphylococcal scalded skin syndrome ssss is a disease, caused by a type of bacteria, in which large sheets of skin may peel away. The staphylococcal scalded skin syndrome may be a consequence of cellulitis, an infection caused by the staphylococcus aureus bacteria as well. This skin condition is characterized by painful and widespread erythema, blistering and its hallmark sign. Staphylococcal scalded skin syndrome due to burn wound infection farroha a.
In its severe form, the exfoliation can spread to cover the entire body surface area. Staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. Whereas ten is a devastating disease of multiple causes and of high fatality affecting all age groups, ssss comprises many clinical entities that occur. Contrast with bullous impetigo, where localized infection spreads contiguously. The production of staphylococcal exfoliative toxin a eta and toxin b etb, toxic shock syndrome toxin tsst1, and enterotoxins ae was analyzed in 60 staphylococcus aureus strains isolated from children with scalded skin syndrome 15 with generalized exfoliative syndrome, 28 with bullous impetigo, and 17 with staphylococcal scarlet fever. These include food poisoning, toxic shock syndrome tss and the scalded skin syndrome. Staphylococcus is a type of bacterium of which there are more than 30 different varieties.
For example in tss, vaginal colonization rather than infection is the rule. However, many healthy people carry staph bacteria in a number of places on the. Hematologic dissemination of staphylococcus aureus from an infectious source e. Ssss is caused by a type of bacteria called staphylococcus aureus. An apparently healthy 64yearold man developed severe septicemia due to a phage group 2 staphylococcus that was followed by a widespread, bullous eruption characterized by intraepidermal cleavage.
Laboratory studies used in the diagnosis generally include culture and serum antibody testing. Staphylococcal scalded skin syndrome ssss is a potentially life. Recent developments in staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome nord national. Appropriate antibiotic therapy is the main component of treatment. Rarely, severe cases may require treatment in a burn center, but aggressive debridement of blisters and. Previous terms for ssss in newborn infants include ritters disease and pemphigus neonatorum. Harmless colonization of the nasal membranes and skin with staphylococcus aureus is common in the community, but the organism can also cause a variety of infections. Staphylococcal scalded skin syndrome ssss is caused by the exfoliative toxins ets of staphylococcus aureus. It tells you what it is, what causes it, what treatment is available, and where you can find out more about it. Typically affects age staphylococcus aureus from an infectious source e.
Staphylococcal scalded skin syndrome describes a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of staphylococcus aureus. St andrews centre for plastic surgery and burns, broomfield hospital, chelmsford, united kingdom summary. Aug 31, 2016 the symptoms of staphylococcal scalded skin syndrome ssss include blistering of skin on superficial layers due to the exfoliative toxins released from staphylococcus aureus. Isolate analyses included pcr for agr group, pvl luksfpv, tst, eta and etb, pulsedfield gel electrophoresis, multilocus sequence typing and antimicrobial. The primary infection often begins during the first few days of life in the umbilical stump or diaper area. Staphylococcus aureus strains that carry exfoliative toxins a and b only 5% of s. The primary infection often begins during the first few days of life in. The disease presents with the widespread formation of fluidfilled blisters that are thin walled and easily ruptured, and the patient can be positive for nikolskys sign. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Staphylococcal scalded skin syndrome is the severe condition caused by exfoliative staphylococcal toxins and is characterized by systemic signs and symptoms and generalized involvement of the skin fig. A double outbreak of exfoliative toxinproducing strains of staphylococcus aureus in a maternity unit volume 112 issue 1 j.
Staphylococcus scalded skin syndrome staphylococcus scalded skin syndrome is caused by toxins produced when a staph infection gets too severe. Staphylococcal scalded skin syndrome dermatologic disorders. It causes the skin to become red, sore and blistered. This bacteria produces a chemical called an epidermolytic toxin epiderm, deriving from the greek words epi, meaning on, and derma, meaning skin, refers to the top layer of skin. Differential diagnosis includes toxic epidermal necrolysis, staphylococcal scalded skin syndrome, epidermolysis bullosa, and stevensjohnson syndrome. The essential clinical features of staphylococcal scalded skin syndrome ssss and other forms of toxic epidermal necrolysis ten are contrasted. This bacterium produces an exfoliative toxin that causes the outer layers of. Staphylococcal scalded skin syndrome in a 4yearold child. Staphylococcal scalded skin syndrome is more common in newborns than in adults. Child abuse by burning comprises 620% of all child abuse cases, but misdiagnosis may arise in cases of some medical conditions.
When staphylococcus aureus infects the skin, it can cause small blisters to appear at the. Foci of infection include the nasopharynx and, less commonly, the umbilicus, urinary tract, a superficial abrasion, conjunctivae, and blood. Product of staphylococcus aureus responsible for the. Pdf staphylococcal scalded skin syndrome in a neonate. Staphylococcusscalded skin syndrome is a skin infection caused by a. The desquamation worsened and the erythema gradually faded. Why do only certain strains of staphylococcus aureus cause scalded skin syndrome. Staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever. Ssss or staphylococcal scalded skin syndrome is a skin condition caused by toxic strains of the bacteria, staphylococcus aureaus. Staphylococcal scalded skin syndrome must be distinguished from toxic epidermal necrolysis, a. This condition is characterized by blistering in the skin surface which more or less looks like a burn and that is what gives it the name of staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome ssss is an uncommon, superficial blistering skin condition, characterised by widespread erythema and exfoliation, mainly occuring in children under five years of age, although older children and adults can be affected. It is a rare condition, which tends to occur in younger children.
Clusters of ssss cases epidemics can occur in newborn nurseries, when staff in. Morel, in comprehensive pediatric hospital medicine, 2007. Your child may need to be admitted to the hospital for more extensive treatment. Staphylococcal scalded skin syndrome is caused by a staphylococcus or staph infection. Staphylococcal scalded skin syndrome is a potentially life. He was discharged on the 8th day after admission fig. Apr 05, 2018 staphylococcal scalded skin syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria staphylococcus aureus. More than 70 different potential virulence factors have been identified in s. The diagnosis is based on clinical data, histology and primary. Staphylococcal scalded skin syndrome almost always affects. The symptoms of staphylococcal scalded skin syndrome ssss include blistering of skin on superficial layers due to the exfoliative toxins released from staphylococcus aureus. Staphylococcal scalded skin syndrome is an exfoliating skin disease which primarily affects children. Ssss is caused by the exfoliative toxins epidermolytic toxins a and b of some strains of staphylococcus aureus. Oral antibiotics are also used after few days of treatment to replace antibiotics of i.
Toxic shock syndrome d scalded skin syndrome e all of the above. In this infection, skin surface of large parts of body gets peeled off and looks like burned skin by hot liquid. Staphylococcal scalded skin syndrome mimicking child abuse. Communityacquired methicillinresistant staphylococcus aureus skin infections. It is characterized by a fever, rash, and blisters. Staphylococcus commonly causes skin infections such as boils.
Staphylococcal scalded skin syndrome information for parents. After the acute exfoliation of skin surface, erythematous cellulitis occurs. Certain staphylococcus aureus strains of phage group 2 produced a protein distinct from the alpha and delta toxins which was capable of causing generalized exfoliation in neonatal mice and presumably is responsible for the scaldedskin syndrome in humans. Staphylococcal scalded skin syndrome is a widespread painful rash caused by a bacteria called staphylococcus aureus, which produces a toxin that damages the outer layer of the skin causing it to be shed. Staphylococcus scalded skin syndrome ssss ritters disease. Staphylococcal scalded skin syndrome is an infection of the skin. Staphylococcal scalded skin syndrome definition of. The staphylococcal scalded skin syndrome is an acute exfoliation of the skin caused by exfoliative toxins a and b. Toxic shock syndrome toxin1 tsst1 superantigen associates with fever, shock, desquamative skin rash of toxic shock syndrome in humans. Description ssss primarily strikes children under the age of five, particularly infants. Ssss is caused by the release of two exotoxins epidermolytic toxins a and b from toxigenic strains of the bacteria staphylococcus aureus.
Staphylococcal scalded skin syndrome is caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55, which are present at localized sites of infection. Staphylococcal scalded skin syndrome knowledge for medical. What is staphylococcal scalded skin syndromecausessymptoms. Staphylococcal scalded skin syndrome ppt xpowerpoint. Staphylococcus aureus is the most common form associated with disease. Mar 28, 2014 staphylococcal scalded skin syndrome is caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55, which are present at localized sites of infection. Epidemiology of staphylococcal scalded skin syndrome in u. To our knowledge, this is the first welldocumented report of staphylococcal scalded skin syndrome occurring in a normal adult.
Staphylococcal scalded skin syndrome ssss is an illness characterised by red blistering skin that looks like a burn or scald, hence its name staphylococcal scalded skin syndrome. Staphylococcus aureus bacteria are grampositive cocci that cause diseases of varying severity, from skin and softtissue infections eg, folliculitis, impetigo, cellulitis, abscesses to deepseated infections eg, endocarditis, osteomyelitis. Gram positive bacteria staphylococcus flashcards quizlet. Increasing numbers of staphylococcal scalded skin syndrome. We present two cases of suspected inflicted burns, later diagnosed as staphylococcal scalded skin syndrome ssss. Microbiological characteristics of exfoliative toxinproducing staphylococcus aureus. The patient responded well to the treatment, which included an. Hence, while diagnosing ssss, it is essential to differentiate it from such similar conditions in order to facilitate the development of an optimum treatment plan. Epidemiological data of staphylococcal scalded skin syndrome in france from 1997 to 2007 and microbiological characteristics of staphylococcus aureus associated strains. This infection produces a toxin that can affect skin all over the body. Staphylococcusscalded skin syndrome staff lo cok us skawl did skin sin drome, also known as scalded skin syndrome, ssss, or ritters disease, is a skin infection caused by a bacteria called staphylococcus aureus. Patients with ssss were identified by icd910 codes and available s. Staphylococcal scalded skin syndrome describes a spectrum of superficial.
Staphylococcal scalded skin syndrome is caused by group ii coagulasepositive staphylococci, usually phage type 71, which elaborate exfoliatin also called epidermolysin, a toxin that splits the upper part of the epidermis just beneath the granular cell layer by targeting desmoglein1 see also staphylococcal infections. This protein, named exfoliatin, was purified and found to have a molecular weight of approximately 24,000. Pdf staphylococcal scalded skin syndrome ssss is the clinical term used for a spectrum of blistering skin diseases induced by the exfoliative. Staphylococcal scalded skin syndrome ssss followup. Staphylococcal scalded skin syndrome ssss is a dermatological condition caused by staphylococcus aureus. Pdf staphylococcal scalded skin syndrome in a newborn. Epidemiological studies of ssss in france and germany found. Staphylococcal scalded skin syndrome as a complication of septic arthritis. Staphylococcal scalded skin syndrome ssss is the medical term used to define a skin condition induced by the exfoliative toxins produced by staphylococcus aureus. Staphylococcus commonly causes skin infections such as boils or impetigo. Treatment of ssss usually requires hospitalisation, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. Staphylococcal scalded skin syndrome almost always affects children 22. It is important to make a diagnosis early, particularly to differentiate it from ten, which has a different management and much greater. Staphylococcal scalded skin syndrome pictures, treatment.
Staphylococcal scalded skin syndrome primarily affects children and can cause serious morbidity. Staphylococcal scalded skin syndrome british association of. We present a case of a 3 days old infant with complaints of fever and diffuse. Ritters disease of the newborn is the most severe form of ssss. The diagnosis of staphylococcal scalded skin syndrome was reached on. Find powerpoint presentations and slides using the power of, find free presentations research about staphylococcal scalded skin syndrome ppt.
Staphylococcal scalded skin syndrome 4s is caused by toxins produced by staphylococcus aureus1,2. These blisters have the appearance of a scald or a burn, hence its name. Staphylococcal scalded skin syndrome ssss aka toxigenic staphylococcal disease. View and download powerpoint presentations on staphylococcal scalded skin syndrome ppt. Pdf staphylococcal scalded skin syndrome researchgate. Staphylococcal scalded skin syndrome causes, symptoms. Toxigenic strains can cause toxic shock, staphylococcal scalded skin syndrome ssss, and staphylococcal food poisoning. Staphylococcus aureus is commonly found on human skin and begins colonization immediately after birth. In general, the patient of ssss gets discharged from. A case of abortive staphylococcal scalded skin syndrome. Home topics az staphylococcal scalded skin syndrome images. The disorder is also known as ritter disease, bullous impetigo, neonatal pemphigus, or staphylococcal scarlet fever.
Staphylococcal scalded skin syndrome ssss is a potentially serious acute skin condition caused by the exfoliative toxins of staphylococcus aureus and typically affects infants and young children. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may. Scalded skin syndrome is a skin reaction to a bacterial infection called staphylococcus aureus. Staphylococcal scalded skin syndrome linkedin slideshare. Staphylococcal scalded skin syndrome images dermnet nz. The infection is more common in children under the age of 5 and for this reason, specialists suspect that the ssss may be due to the fact that the kidneys are not developed properly and cannot filter. Start studying gram positive bacteria staphylococcus. Staphylococcal scalded skin syndrome is caused by bacteria called staphylococcus aureus. These illnesses may occur in the absence of a site of infection.
Mrsa, staphylococcal scalded skin syndrome, and other. Toxin involvement in staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome in an adult jama. Staphylococcal scalded skin syndrome ssss is a bacterial toxinmediated skin disorder that primarily affects young children but can also occur in older children and adults. Breaks down desmoglein1 resulting in acantholysis breakage of cell to cell adhesions. May 02, 20 staphylococcal scalded skin syndrome differential diagnosis there are a number of skin disorders which show signs and symptoms similar to that of ssss.
1218 1424 105 644 1174 275 706 160 333 735 1073 532 1089 824 147 1231 895 1283 1492 1425 1353 792 1138 893 973 410 1428 493 705 372 300 1377 1027 802 144 745 861 400 465 567 766