1. Bubbling of Skin! By: Faith Efada David Hernandez Zenona Hammond

2. Case 6 year old girl admitted to hospital Acute Blistering of her left arm and hand Normal Vital signs After Examination Burns were suspected Conformation of non exposure to burning agents

3. Differentials Abuse Burns Chemical Thermal Contact Allergy Dermatis Folliculitis SSSS(Staphylococcal Scalded Skin Syndrome) Inpetigo Toxic Epidermal Necrolysis Rhus Dermatitis Urticaria

4. Questions Has she been around poison ivy and oak? Has she been around poison ivy and oak? Does she have any allergies? Does she have any allergies? Has she traveled anywhere recently? Has she traveled anywhere recently? Do any of her family members have any similar symptoms? Do any of her family members have any similar symptoms? Ask the child if her parents have hurt her in any way. Ask the child if her parents have hurt her in any way. Is she allergic to any medications? Is she allergic to any medications? Is she currently taking any medications? Is she currently taking any medications?

5. What is it? And how do we know? Staphylococcus Scalded Skin Syndrome Staphylococcus Scalded Skin Syndrome Staphylococcus aureus Staphylococcus aureus GPC in Clusters GPC in Clusters No Abuse No Abuse Not been around poison ivy or oak Not been around poison ivy or oak Contact Allergy/Rhus Dermatitis Contact Allergy/Rhus Dermatitis

6. Continued... Not on any meds. Not on any meds. No Necrosis No Necrosis Toxic Epidermal Necrosis Toxic Epidermal Necrosis Type 1 Hypersensitivity Type 1 Hypersensitivity Urticaria Urticaria

7. SSSS Exotoxin Exotoxin A & B A & B Oral/Nasal Cavities Oral/Nasal Cavities Throat Throat Umbilicus Umbilicus Binding of toxin btwn cells forming a blister Binding of toxin btwn cells forming a blister Red Rash Red Rash Separation of Epidermis Separation of Epidermis Granular Cell Layer Granular Cell Layer

8. Tests Culture Culture MSA MSA Yellow Yellow Gram Stain Gram Stain GPC GPC Catalase & Coagulase Catalase & Coagulase Positive Positive

9. Portal of Entry Person-to-person contact Person-to-person contact Enters skin Enters skin Cuts Cuts Wounds Wounds Any broken skin Any broken skin Touching of infected areas can aid in spreading Touching of infected areas can aid in spreading

10. Prognosis Mortality Children very low 1-5% Death Secondary infection

11. Treatment Sensitivity test results Sensitivity test results Resistant Resistant Penicillin Penicillin Amoxicillin Amoxicillin Tetracycline Tetracycline Cephalexin Cephalexin Naficillin Naficillin Vancomycin Vancomycin VRSA (Vancomycin Resistant Staphylococcus Aureus) VRSA (Vancomycin Resistant Staphylococcus Aureus) Sensitive Sensitive Ciprofloxacin Ciprofloxacin

12. Treatment Cont… As if she were a burn patient As if she were a burn patient Cleaning of the wounds Cleaning of the wounds Wrapping Wrapping Monitoring Vitals Monitoring Vitals Fluid input and output Fluid input and output Nutrition Nutrition

13. Prevention Isolation Isolation Proper PPG Proper PPG Non-disposable items to use on a specific individual Non-disposable items to use on a specific individual Educate Educate Out of school Out of school

14. Work Cited Anderson, Douglas. Mosby’s Medical Dictionary. St Louis: Mosby’s Inc., 2002. Anderson, Douglas. Mosby’s Medical Dictionary. St Louis: Mosby’s Inc., 2002. Bauman, Robert. Microbiology: Alternate Edition with Diseases by Body System. San Francisco.Pearson Education Inc., 2006. Bauman, Robert. Microbiology: Alternate Edition with Diseases by Body System. San Francisco.Pearson Education Inc., 2006. King, Randall, and de Saint Victor, Paul. “Staphylococcal Scalded Skin Syndrome.” emedicine Instant Access to the Mind of Medicine. 1 April 2006. http://www.emedicine.com/emerg/topic782.htm# section~introduction King, Randall, and de Saint Victor, Paul. “Staphylococcal Scalded Skin Syndrome.” emedicine Instant Access to the Mind of Medicine. 1 April 2006. http://www.emedicine.com/emerg/topic782.htm# section~introduction http://www.emedicine.com/emerg/topic782.htm# section~introduction http://www.emedicine.com/emerg/topic782.htm# section~introduction