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cbreland
I agree with this explanation. Thought that they would make us decide between S aureus and GAS (bullous v. non-bullous impetigo) but seems like they went easy on us
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jer040512
It sounded more like Scalded Skin Syndrome to me. I saw this in Amboss and thought i'd post it here. "SSSS belongs to the spectrum of diseases mediated by specific staphylococcal toxins, which also includes bullous impetigo, toxic shock syndrome (TSS), and Staphylococcus aureus food poisoning. Unlike TSS, SSSS does not have systemic manifestations (e.g., liver, kidney, bone marrow, and CNS involvement)!"
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jer040512
It sounded more like Staph Scalded Skin Syndrome to me. Here's what i found on AMBOSS.
SSSS belongs to the spectrum of diseases mediated by specific staphylococcal toxins, which also includes bullous impetigo, toxic shock syndrome (TSS), and Staphylococcus aureus food poisoning. Unlike TSS, SSSS does not have systemic manifestations (e.g., liver, kidney, bone marrow, and CNS involvement)!
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jer040512
It sounded more like Scalded Skin Syndrome to me. I saw this in Amboss and thought i'd post it here. "SSSS belongs to the spectrum of diseases mediated by specific staphylococcal toxins, which also includes bullous impetigo, toxic shock syndrome (TSS), and Staphylococcus aureus food poisoning."
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jer040512
I thought this was Scalded Skin Syndrome. Here's what I got from AMBOSS.
SSSS belongs to the spectrum of diseases mediated by specific staphylococcal toxins, which also includes bullous impetigo, toxic shock syndrome (TSS), and Staphylococcus aureus food poisoning. Unlike TSS, SSSS does not have systemic manifestations (e.g., liver, kidney, bone marrow, and CNS involvement)!
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plaguedbyspleen
Staphylococcal scalded skin syndrome differs from bullous impetigo. Both are blistering skin diseases caused by staphylococcal exfoliative toxin. However, in bullous impetigo, the exfoliative toxins are restricted to the area of infection, and bacteria can be cultured from the blister contents. In staphylococcal scalded skin syndrome the exfoliative toxins are spread hematogenously from a localized source causing widespread epidermal damage at distant sites.
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jaramaiha
This isn't TSST but rather bullous impetigo infected w/ S. aureus. FA20 pg479 at the top. This question was mentioned in AMBOSS as well.
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jhoplite
^^^ Agreed, to add to @jaramaiha, "Bullous impetigo is a superficial skin infection caused by the same toxin-producing strains of S. aureus associated with SSSS. Bullous impetigo most often occurs in young children and presents with vesicles, flaccid bullae..."
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submitted by โbaja_blast(219)
I'm skeptical of this being Toxic Shock Syndrome, as the rash in TSS is usually described as being similar to that of a severe sunburn and, besides fever, there are no other associated TSS symptoms (hypotension, shock, vomiting, abnormal LFTs, etc). Moreover, questions about TSS usually mention nasal packing or a left-in tampon, both of which are absent in this three year old boy. You can read about TSS in FA 2019 on p. 135.
I think it's more likely that this is Bullous Impetigo, which is mentioned briefly on FA 2019 p. 470 as being caused by S. Aureus.
Either way, both are caused by S. Aureus so even if you thought this was TSS you should still get the right answer here.