Staphylococcal Scalded Skin Syndrome in a 5-Year-Old Girl
Case at a Glance
A 5-year-old girl presented with progressive skin manifestations initially mimicking an allergic reaction, subsequently diagnosed as Staphylococcal Scalded Skin Syndrome (SSSS) with concerns about treatment response during hospitalization.
Patient's Story
The patient initially developed periorbital edema and erythema in the axillary region, which the family attributed to potential allergen exposure. Home treatment with antihistamines was initiated. Within 24 hours, the rash had progressed to involve all intertriginous areas with associated pain, prompting medical evaluation.
Initial Assessment
The patient was initially evaluated by her pediatrician who suspected scarlet fever based on the distribution and appearance of the rash. Oral antibiotic therapy was prescribed with specific instructions to seek emergency care if skin desquamation developed. The patient remained afebrile except for one documented temperature of 100.4°F (38°C) at home.
The Diagnostic Journey
Following the pediatrician's warning signs, the family noticed skin wrinkling and textural changes that evening, prompting emergency department evaluation. After prolonged wait time, pediatric consultation confirmed the diagnosis of Staphylococcal Scalded Skin Syndrome based on clinical presentation and skin findings.
Final Diagnosis
Staphylococcal Scalded Skin Syndrome (SSSS)
Treatment Plan
Intravenous antibiotic therapy was initiated following hospital admission. The patient was placed under close monitoring for disease progression and treatment response.
Outcome and Follow-up
After 72 hours of antibiotic treatment, the patient developed new areas of erythema on the extremities, representing either disease progression or treatment failure. The clinical team was consulted regarding this development, though definitive assessment of treatment efficacy remained unclear at the time of documentation. Continued inpatient monitoring and possible treatment modification were being considered.