ブドウ球菌性熱傷様皮膚症候群─広範囲にびらんを呈した新生児例─

・発熱と白血球数減少を認め小児敗血症の診断基準を満たし，体表面積の約90％にまでびらんが拡大した．・NICU（新生児集中治療室）において，バンコマイシン（VCM）投与と免疫グロブリン大量静注療法を行った．・保育器での湿度，温度管理や輸液等の熱傷に準じた全身管理も並行して行った．・ブドウ球菌性熱傷様皮膚症候群（staphylococcal scalded skin syndrome：SSSS）では患者背景や重症度に応じた治療を選択することが重要と考えられた．（「症例のポイント」より）

Staphylococcal skin scalded syndrome–A case of neonatal with extensive erosions–

Nakanishi, Mari1）Nakagawa, Hiroki2）Murata, Mariko2）Kanno, Satoshi2）Nagata, Makoto2） 1）Department of Dermatology, Kyoto Prefectural University of Medicine 2）Department of Dermatology, Japanese Red Cross Kyoto Daiichi Hospital

Abstract A 7-day-old female neonate presented erosions on the left axilla, back and around the mouth with fever. We clinically suspected staphylococcal skin scalded syndrome (SSSS) and treated her initially with cefazolin. Howver the erosions expanded rapidly almost to the whole body with a decrease in white blood cells suggesting neonatal sepsis. We treated her by change of the antibiotic to vancomycin combined with intravenous immunoglobulin (IVIg) therapy. It is important to select treatments according to the patients’ severity and background factors.