Diagnosing and managing staphylococcal scalded skin syndrome in adults
In adults, staphylococcal scalded skin syndrome is associated with significant morbidity and mortality. Adults are managed differently to children as they are more likely to have sepsis and septic shock. For management of children with staphylococcal scalded skin syndrome, see Diagnosing and managing staphylococcal skin syndrome in children.
In adults with staphylococcal scalded skin syndrome, collect blood samples for culture; blood culture results are typically positive for Staphylococcus aureus. In addition to blood samples, all potential sites of infection should be cultured. In adults, the most common primary infections include abscesses, arteriovenous fistula infection, pneumonia and septic arthritis. The blisters and bullae in staphylococcal skin syndrome are sterile, so there is little benefit in culturing these.
Manage staphylococcal scalded skin syndrome in adults as for S. aureus bacteraemia.
For adults with staphylococcal scalded skin syndrome who have sepsis or septic shock, start antibiotic therapy within 1 hour of presentation to medical care or, for ward-based patients, development of sepsis or septic shock. Antibiotics should be administered immediately after blood samples are taken for culture. Collect samples from all potential sites of infection as soon as possible; however, do not delay antibiotic administration to do so. For nonantibiotic management of sepsis or septic shock, see Resuscitation of patients with sepsis or septic shock.