Clinical analysis of 177 cases of staphylococcal scalded skin syndrome

Abstract

Objective To assess the diagnosis and treatment of staphylococcal scalded skin syndrome (SSSS)in children.Methods A total of 177 children whh SSSS were eligible for this study.Clinical data were retrospectively reviewed to assess the patients' age and geographical areas,predisposing factors,prodrome,clinical features,results of laboratory examination (including bacterial isolation and drug susceptibility test),treatment and prognosis.Results The median age at onset was 23 days past 15 months.Infants aged 1 to 3 years were the most commonly affected population.The male to female ratio was 8:9.SSSS occurred in summer or autumn in 71.2％ of the patients.Most patients came from countryside.Of these patients,148 (83.6％) had no definite inducement,13 (7.3％) had fever or cold history before the occurrence of SSSS.Skin lesions often began in the face (71.6％).Almost all cases presented with erythema and blisters.Abnormal myocardial enzymes were observed in 104 (80.6％) of 129 patients,and Staphylococcus aureus was isolated from 38.7％ of 142 patients.Susceptibility testing of 21 Staphylococcus aureus isolates from patients in the past 3 years showed that 95.2％ and 95.0％ were sensitive to cephalosporins and amoxicillin/clavulanic acid respectively.Double-antibiotic therapy was effective in 72.9％ of the patients.Intravenous gamma globulin was given to 36.2％ of the patients in the early stage.Myocardial-protecting drugs were also administrated early in patients with abnormal myocardial enzymes.All the patients healed without scarring.Conclusions For infants with acute facial erythema and exfoliative skin lesions,SSSS should be suspected and timely antibiotic treatment should be given.Cephalosporins and semi-synthetic penicillins are effective and the first choice for the treatment of SSSS.Meanwhile,early addition of gamma globulin and myocardial-protecting drugs may be beneficial to disease recovery.