Assadian Afshin, Assadian Ojan, Simon Arne, Kramer Axel
Department of General and Vascular Surgery, Wilhelminenspital, Vienna, Austria.
GMS Krankenhhyg Interdiszip. 2009 Dec 16;4(2):Doc05. doi: 10.3205/dgkh000130.
Childhood exanthemata are caused by a broad spectrum of common pathogens. Many exanthemata initially present very similarly, even though caused by different organisms, ranging from virus to bacteria and their respective toxins. In the majority of cases the diagnosis is only of academic value, since therapy does hardly differ. However, in some cases accurate and prompt diagnosis is paramount, since therapy and appropriate hygiene measures prevent morbidity and mortality. We present a case with two differential diagnoses, Staphylococcal Scalded Skin Syndrome and Kawasaki Syndrome, which demonstrates the importance of considering relatively rare conditions as the cause of a childhood exanthema and discuss differences in therapeutic and infection control management. From an infection control point of view, Staphylococcal Scalded Skin Syndrome is, in contrast to Kawasaki Syndrome, highly transmittable to other paediatric patients via the hands of the staff. Therefore maintaining correct hand hygiene as well as other infection control measures are of importance until the final diagnosis is established.
儿童疹病由多种常见病原体引起。许多疹病最初表现极为相似，尽管由不同生物体引发，从病毒到细菌及其各自毒素都有。在大多数情况下，诊断仅具有学术价值，因为治疗方法几乎没有差异。然而，在某些情况下，准确及时的诊断至关重要，因为治疗和适当的卫生措施可预防发病和死亡。我们呈现一个具有两种鉴别诊断的病例，即葡萄球菌性烫伤样皮肤综合征和川崎病，该病例展示了将相对罕见病症视为儿童疹病病因的重要性，并讨论了治疗和感染控制管理方面的差异。从感染控制角度来看，与川崎病相比，葡萄球菌性烫伤样皮肤综合征可通过医护人员的手高度传染给其他儿科患者。因此，在确定最终诊断之前，保持正确的手部卫生以及其他感染控制措施非常重要。
