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Bubbling of Skin! By: Faith Efada David Hernandez Zenona Hammond 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 Differentials Abuse Burns Chemical Thermal Contact Allergy Dermatis Folliculitis SSSS(Staphylococcal Scalded Skin Syndrome) Inpetigo Toxic Epidermal Necrolysis Rhus Dermatitis Urticaria Questions Has she been around poison ivy and oak? Does she have any allergies? Has she traveled anywhere recently? Do any of her family members have any similar symptoms? Ask the child if her parents have hurt her in any way. Is she allergic to any medications? Is she currently taking any medications? What is it? And how do we know? Staphylococcus Scalded Skin Syndrome Staphylococcus aureus GPC in Clusters No Abuse Not been around poison ivy or oak Contact Allergy/Rhus Dermatitis Continued. . . Not on any meds. No Necrosis Toxic Epidermal Necrosis Type 1 Hypersensitivity Urticaria SSSS Exotoxin A&B Oral/Nasal Cavities Throat Umbilicus Binding of toxin btwn cells forming a blister Red Rash Separation of Epidermis Granular Cell Layer Tests Culture MSA Yellow Gram Stain GPC Catalase & Coagulase Positive Portal of Entry Person-to-person contact Enters skin Cuts Wounds Any broken skin Touching of infected areas can aid in spreading Prognosis Mortality Children very low 1-5% Death Secondary infection Treatment Sensitivity test results Resistant Penicillin Amoxicillin Tetracycline Cephalexin Naficillin Vancomycin VRSA (Vancomycin Resistant Staphylococcus Aureus) Sensitive Ciprofloxacin Treatment Cont… As if she were a burn patient Cleaning of the wounds Wrapping Monitoring Vitals Fluid input and output Nutrition Prevention Isolation Proper PPG Non-disposable items to use on a specific individual Educate Out of school Work Cited 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. 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