Staphylococcus-Scalded Skin Syndrome :: Nationwide Children's Hospital

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Staphylococcus-Scalded Skin Syndrome (SSSS) (Ritter's Disease)

Staphylococcus-Scalded Skin Syndrome (STAFF lo cok us SKAWL did skin SIN drome), also known as Scalded Skin Syndrome, SSSS, or Ritter’s Disease, is a skin infection caused by a bacteria called Staphylococcus aureus. This infection produces a toxin that can affect skin all over the body. Often the skin becomes damaged and sheds.
SSSS is not a common condition. The Staph bacterium that causes SSSS can be passed from person to person (contagious). However, many healthy people carry Staph bacteria in a number of places on the body, such as the surface of the skin or in their noses, without getting sick. Children under the age of 5 years, people with poor immunity and those with poor kidney function are at greater risk for developing SSSS.

Signs and Symptoms

Early signs

  • Fatigue
  • Fever
  • Irritability
  • Loss of appetite
  • Decrease in wet diapers
  • Reddened rash

Later signs

  • Skin tenderness or pain
  • Blisters
  • Peeling skin

Diagnosis

Along with medical history and physical examination, diagnosis can be confirmed with:

  • Skin biopsy (a sample of the skin looked at under a microscope)
  • Culture of skin (a swab of skin, nose, eye and throat to look for signs of Staph aureus)
  • Nikolsy’s sign (a blister formed from slight rubbing pressure on the skin)
  • Additional blood tests

Treatment

Depending on how serious the infection is, your child may get oral or IV (intravenous) antibiotics and pain medicine. Your child may need to be admitted to the hospital for more extensive treatment. In the hospital your child may get IV fluids to keep him or her from getting dehydrated. Any affected skin that he or she may have may be covered in a gauze or similar dressing.

Image of parent and child

What to Do and What to Watch for at Home

  • Encourage your child to drink a lot of fluids.
  • Keep affected skin covered and clean.
  • Wash your hands often, especially before and after contact with your child.
  • Give your child medicines as ordered by your doctor.

Call your child’s doctor if the child has worsening symptoms or persistent fever.

Activity and Diet

Be sure your child has enough rest and sleep. He or she may have the usual foods along with plenty of fluids. It is important to provide foods rich in nutrients, especially protein, to help with skin healing. Foods with protein include meats, eggs, milk and beans.

Staphylococcus-Scalded Skin Syndrome (PDF)

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