Like the other pediatric emergencies Dr. Pride discussed, this diagnosis is made clinically; good diagnostic tests are lacking.
Early treatment is important, because mortality ranges from 20% to 80% in untreated cases and is about 4% among treated cases.
Tetracyclines are the treatment of choice, with doxycycline preferred in patients younger than 8 years. Chloramphenicol is another treatment option.
Supportive care—often with intravenous hydration, supplemental oxygen and red blood cells—also is of benefit, he said.
Abrupt and extreme pain marks the onset of scalded skin syndrome. Staphylococcus often is the pathogen.
Chemotherapy increases vulnerability to ecthyma gangrenosum. Pseudomonas aeruginosa may cause it.
Meningococcemia is marked by rapid onset and petechial rash of skin and mucous membranes. Photos courtesy Dr. Howard Pride