Diferencia entre revisiones de «Staphylococcal scalded skin syndrome»
Sin resumen de edición |
|||
| Línea 17: | Línea 17: | ||
**If possible MRSA: | **If possible MRSA: | ||
***Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d | ***Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d | ||
***Bactrim 10 mg/kg/d in 2 divided doses x7-10d | ***[[Bactrim]] 10 mg/kg/d in 2 divided doses x7-10d | ||
***Vancomycin 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr | ***Vancomycin 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr | ||
Revisión del 05:45 27 feb 2014
Background
- Most pts <2yr old, nearly all <6 yr old
Diagnosis
- Rash progresses from erythroderma to extensive areas of exfoliation
- Systemic symptoms (malaise, fever, irritability, skin tenderness) are common
- Nikolsky sign (separation of epidermis when pressure is applied) is present
Treatment
- Often requires inpt therapy, fluid resuscitation, parenteral antibiotics
- Antibiotics
- Nafcillin 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d
- Penicillin G procaine (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg)
- Amoxicillin-clavulanate 45 mg/kg/d PO in 2 divided doses x 7-10d
- Cefazolin 100 mg/kg/d IV in 4 divided doses
- Cephalexin 40 mg/kg/d in 4 divided doses x 7-10d
- If possible MRSA:
- Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d
- Bactrim 10 mg/kg/d in 2 divided doses x7-10d
- Vancomycin 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr
Disposition
- Transfer to burn center if diffuse
- Localized infection may d/c home w/ f/u
Source
Tintinalli