Question

A 9 month old Caucasian infant is brought to the ED. His mom reports a hx of fever, lethargy, rhinorrhea, and irritability for several days. Upon exam, the APRN notes pharyngeal erythema, as well as generalized erythema covering the child's face and trunk with blisters, bullae and "scalding" appearance. What should teh APRN be concerned about?

Answer 1

The APRN should be concerned about a serious condition such as Staphylococcal Scalded Skin Syndrome (SSSS) or another severe bacterial infection in the 9-month-old infant presenting with fever, lethargy, and a scalding skin rash.

Step-by-step explanation:

The APRN should be concerned about a serious condition such as Staphylococcal Scalded Skin Syndrome (SSSS) or another severe infectious process. The described clinical presentation of fever, irritability, rhinorrhea (runny nose), pharyngeal erythema (redness in the throat), and the characteristic generalized erythema with blisters and a scalding appearance of the skin suggest a severe infection that may have systemic implications.

It is critical to differentiate between commonly encountered viral infections presenting with rash and more serious bacterial infections like SSSS, which is caused by exotoxin-producing strains of Staphylococcus aureus. Early recognition and treatment of such infections are paramount as they can progress rapidly and may require systemic antibiotic therapy along with supportive care. This presentation could also be indicative of other serious infections such as invasive Group A Streptococcal infection, which can lead to conditions like toxic shock syndrome or necrotizing fasciitis.