Staphylococcal cutaneous infection in newborn – clinical approach and treatment

Introduction. Staphylococcal scalded skin syndrome (SSSS) is an exfoliating skin disease with two age peak incidence: the neonatal period and early childhood. Differential diagnosis includes bullous impetigo, Stevens-Johnson syndrome, Toxic epidermal necrosis (TEN), oxic shock syndrome, Scarlet fever, Kawasaki disease and Pemphigus. Case presentation. We present a 14-day-old female, from a rural area, admitted in the Pediatrics Clinic with appearance of blistering skin rash on the face and forehead, extending to the chest, abdomen and limbs, with areas of exfoliation and irritability respectively. The positive diagnosis of SSSS was made based upon the medical history (perforation of the auricular lobules, rapid onset of the vesicles that growth and break), physical findings (multiple vesicles and lax blisters, positive Nikolsky sign, perioral crusts, conjunctivitis with purulent secretions, erythema and bilateral palpebral edema) and paraclinical (lesion secretion – saprophytic flora; conjunctival secretion – Staphylococcus aureus MSSA), and adequate therapeutic response respectively. With parenteral antibiotic treatment, hydro-electrolyte rebalancing and rigorous local hygiene the evolution was favorable. Conclusions. Staphylococcus aureus is an important pathogen in the neonatal period. The appropriate diagnosis and treatment of infection with hematogenous dissemination in the skin are necessary to reduce morbidity and mortality.