| IntroductionStaphylococcal scalded skin syndrome is a severe infectious skin disease with an abrupt onset, and is characterized by large areas of skin exfoliation with generalized erythema in the body based on the occurrence of relaxative scalded-like bulla. It is often occurred in children but rarely in adults. The mortality of children patients was 3-4%. The disease begins abruptly and progresses rapidly and extensively. It can not be diagnosed in time often due to delays in diagnosis and treatment, even causing severe sepsis, pneumonia and other life-threatened complications. It is necessary to investigate the incidence of disease in children incentives, clinical features, misdiagnosis causes and treatment experience for future clinical work.Materials and MethodsThe data for retrospective study of 135 patients with clinically diagnosed SSSS were analyzed with application of SPSS17.0 for windows software, t-test, x2 test, Kruskal-Wallis H test and inspection nemenyi method to test the level ofα=0.05.ResultsOnly 49 pre-hospital patients were diagnosed as SSSS, accounting for 36.30% in all patients. Most of the patients was misdiagnosed as "allergic diseases" and treated with anti-allergic therapies.In the study,30 cases (14.8%) have different degrees of lower body weight. The patients with lower total protein accounted for 33.3%, with decreased serum albumin 1.5% and with lower pre-albumin 65.9%.114 cases were detected for serum immunoglobulin levels, in which,37.7% of cases associated with low levels of IgA, 17.5% of cases with low levels of IgG and the levels of IgM were not changed significantly. Serum creatinine (SCr) and blood urea nitrogen (BUN) data were statistically analyzed for all patients. The BUN levels of 50 cases (37.0%) and the SCr levels of 103 cases (76.3%) were slightly lower.Comparing the difference in the days of hospital stay between different treatment groups, the results showed as follows:there were significantly different in hospital days between cephalosporin group and macrolide group, P<0.005; there were no significant difference in hospital days neither between cephalosporin group and the cephalosporin +IVIG group nor between the cephalosporin+IVIG group and macrolide group.Comparing the difference patients'condition between the cephalosporin+IVIG group and the cephalosporin group, the results showed as follows:①The cephalosporin +IVIG group's condition was relatively more serious than the cephalosporin group's. The former group had a higher peak temperature than the latter group, besides, the recovery time of temperature and the relief time of skin pain were longer;②The two groups had no significant difference in the aspects of getting better time,staying hospital days and the final efficacy.Conclusion1. Low level of humoral immunity, low body weight and poor nutrition may be the reasons for children susceptible to SSSS;2. In the treatment for SSSS, the cephalosporin group was superior to the macrolides group with significantly shorter hospital stays;3. The cephalosporin+IVIG therapy for the serious SSSS patients had a significant effect on quickly controling the symptoms and improving conditions;4. SSSS mainly occurs in children aged 1-6 who were generally healthy. It was more common in rural areas than in urban. The autumn and the winter were the seasons of high incidence;5. Impetigo, upper respiratory tract infection, skin trauma, scratches, and skin infections were the predisposing factors of SSSS;... |
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