PEDIATRICS
DIAGNOSIS
Clinical suspicion, confirmed by throat culture positive for strep, or a rising
antistreptolysin-O (ASO) titer.
TREATMENT
Penicillin or erythromycin for 10 days
COMPLICATIONS
■ Rheumatic fever (can be prevented by treating scarlet fever with antibiotics)
■ Glomerulonephritis (not preventedby treating scarlet fever with antibiotics)
STAPHYLOCOCCALSCALDEDSKINSYNDROME
■ Occurs as a result of (usually) clinically inappent colonization with an
exotoxin-producing strain of S. aureus
■ Typically affects children < 5 years of age
SYMPTOMS/EXAM
■ Exanthem: Generalized, tender erythema
■ Skin exfoliates; Nikolsky’s sign: Pressure on affected skin leads to blister
formation
DIFFERENTIAL
■ Toxic epidermal necrolysis
■ Stevens-Johnson syndrome
■ Bullous impetigo
DIAGNOSIS
Clinical diagnosis
TREATMENT
■ Antibiotics (to treat staph infection)
■ IV fluid resuscitation
■ Isolation
COMPLICATIONS
■ Dehydration
■ 2° bacterial infection can occur.
TOXICSHOCKSYNDROME(TSS)
Toxic shock syndrome is triggered by exotoxin releasedue to inflammatory
cascade similar to that seen in sepsis.
Two distinct syndromes:
Staphylococcal toxic shock syndrome (TSS)
■ Due to colonization with exotoxin-producing strain of Staphylococcus aureus
■ Traditionally associated with tampon use