A Desquamating Skin Rash in a Pediatric Patient

Haggerty, John J.; Grimaldo, Felipe

doi:10.5811/cpcem.2019.1.41162

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Among the SSTIs caused by S. aureus , SSSS is unique in that it is mediated by exfoliative toxins A and B, which are the causative agents of symptoms [ 75 , 77 ]. Unless SSSS is quickly diagnosed, patients are at risk for other infections, in addition to sepsis and renal failure [ 78 ]. However, the prognosis for young children with SSSS is generally excellent.…”

Section: Clinical Presentationsmentioning

confidence: 99%

Clinical Impact of Staphylococcus aureus Skin and Soft Tissue Infections

et al. 2023

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The pathogenic bacterium Staphylococcus aureus is the most common pathogen isolated in skin-and-soft-tissue infections (SSTIs) in the United States. Most S. aureus SSTIs are caused by the epidemic clone USA300 in the USA. These infections can be serious; in 2019, SSTIs with S. aureus were associated with an all-cause, age-standardized mortality rate of 0.5 globally. Clinical presentations of S. aureus SSTIs vary from superficial infections with local symptoms to monomicrobial necrotizing fasciitis, which can cause systemic manifestations and may lead to serious complications or death. In order to cause skin infections, S. aureus employs a host of virulence factors including cytolytic proteins, superantigenic factors, cell wall-anchored proteins, and molecules used for immune evasion. The immune response to S. aureus SSTIs involves initial responders such as keratinocytes and neutrophils, which are supported by dendritic cells and T-lymphocytes later during infection. Treatment for S. aureus SSTIs is usually oral therapy, with parenteral therapy reserved for severe presentations; it ranges from cephalosporins and penicillin agents such as oxacillin, which is generally used for methicillin-sensitive S. aureus (MSSA), to vancomycin for methicillin-resistant S. aureus (MRSA). Treatment challenges include adverse effects, risk for Clostridioides difficile infection, and potential for antibiotic resistance.

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Section: Clinical Presentationsmentioning

confidence: 99%

Clinical Impact of Staphylococcus aureus Skin and Soft Tissue Infections

et al. 2023

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Comparison of Clindamycin with Other Anti-staphylococcal Antibiotics for the Treatment of Pediatric Staphylococcal Skin-Scaled Syndrome

Hashemian,

Asgharzadeh,

Baghaei

et al. 2023

Arch Pediatr Infect Dis

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Background: Staphylococcal scalded skin syndrome (4S) is caused by Staphylococcus aureus exfoliative toxin and is characterized by the separation of the surface layers of skin. Given the existence of conflicting treatment strategies and differences in antibiotic resistance patterns, this study aimed to compare the effectiveness of clindamycin, clindamycin with another anti-staph agent, and antibiotic regimen without clindamycin in the management of pediatric 4S. Objectives: To compare the effectiveness of different treatment strategies in the management of pediatric 4S. Methods: In this cross-sectional study, children with 4S (based on the final documented clinical diagnosis) admitted to the 17th-Shahrivar Hospital of Rasht, Iran, from 2005 to 2021 were enrolled. Exclusion criteria comprised being a neonate, having chronic skin diseases or immunodeficiencies, and incomplete data files. The variables gathered included age, sex, type of antibiotic received, time of fever cessation (if fever existed), recovery time, duration of hospitalization, and complications. The data were entered into SPSS v.24 software and analyzed. Results: This study was conducted on 73 patients with the final diagnosis of 4S. The mean age of the patients was 17.70 ± 15.85 months, and 47.9% of them experienced fever during hospitalization. The mean duration of hospital stay was 6.52 ± 1.90 days. Also, the average duration of recovery in these children was 4.90 ± 1.73 days. There were no differences in terms of sex (P-value = 0.245), age (P-value = 0.383), and duration of fever (P-value = 0.568) between the three groups receiving different antibiotic regimens. Meanwhile, the durations of recovery (P-value = 0.018) and hospitalization (P-value = 0.020) were significantly longer in children who did not receive clindamycin. Moreover, the duration of hospitalization was significantly shorter in the patients who received clindamycin alone compared to those treated with clindamycin plus another antibiotic (P-value = 0.044). There was no significant difference in the occurrence of disease/drug complications between the three groups, and the most common complication in all patients was scaling. Conclusions: Clindamycin (alone or in combination with other anti-staphylococcal agents) could shorten the recovery period, and hospital stay in children with 4S. Besides, it did not have any adverse impact on the occurrence of complications. The patients who received clindamycin alone had a shorter hospital stay than patients who were treated with clindamycin plus another antibiotic. Considering the lower complications, lower costs, and shorter length of hospital stay associated with monotherapy, we recommend using clindamycin alone for treating 4S patients.

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A Desquamating Skin Rash in a Pediatric Patient

Cited by 2 publications

References 4 publications

Clinical Impact of Staphylococcus aureus Skin and Soft Tissue Infections

Clinical Impact of Staphylococcus aureus Skin and Soft Tissue Infections

Comparison of Clindamycin with Other Anti-staphylococcal Antibiotics for the Treatment of Pediatric Staphylococcal Skin-Scaled Syndrome

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