Pemphigus of newborns
Bladder of newborns is a bacterial disease characterized by skin lesions with red spots, blisters and ulcers. Usually there is pemphigus in children with decreased immunity. Local symptoms of the disease will be hyperemia in certain areas of the skin and painful vesicles. There are also common symptoms: fever, weakness, anxiety. Babies up to 15 days after birth may become infected with a pimple. The cause of the disease is infection with staphylococcal infection. There are several forms of pemphigus. The treatment should be attended not only by doctors, but also by young parents.
Pimple of newborns: causes of
The causative agent of pemphigus is Staphylococcus aureus, which enters the child's body through microdamages. Infection affects all layers of the skin. When the infection enters the body, it produces a toxic substance - exfoliatin, which has a pathological effect on the skin and damages it.
The skin of a newborn is very tender, has weak immunity and can easily be damaged. Staphylococcus enters the skin during childbirth from mother to baby, where the child's skin can be unnoticeably injured. In this case, omphalitis may occur - inflammation of the wound of the navel of the newborn, and later the pemphigus of the newborn also occurs. Staphylococcus aureus is found in 40% of women in the genitourinary system. In addition, the mother may be ill on various skin diseases( or in her body is the focus of purulent inflammation).
Causes that increase the risk of developing pemphigus in a newborn are reduced immunity, birth trauma, prematurity or immaturity of the baby at the time of delivery. Also, a toddler can get infected in a hospital, 30% of medical personnel can have a pathogen in the body. In case of poor cleaning of premises, processing of tools, quartz of separate premises, processing of bandages and medical napkins, hands of medical personnel or non-observance of hygiene rules, staphylococcus may not be destroyed and get on the injured skin of the baby. Also, medical workers at the maternity hospital can be ill with inflammatory skin diseases and, when taking care of newborns, become a source of infection.
Pemphigus of newborns occurs when a number of random factors coincide and the presence of reduced immunity of the child.
Pimple of newborns: symptoms of
Pimples of newborns exist in two forms: lighter( benign) and severe( malignant).The disease begins in the child with the formation of hyperemic rashes or peeling. The skin changes color first on the face( near the corners of the mouth) and the tummy( around the navel), then it can spread across all parts of the body. On the spot of these redness there is swelling, swelling and bubbles are formed. Later the bubbles become more flat, the skin over them becomes thinner and breaks out, fluid flows out. At the place of the blisters, there is a shallow skin defect - erosion. With a favorable current, the blisters, and after erosion, have an insignificant size of up to 0.5 cm. If the pemphigus is unfavorable, newborn erosions can be up to 3 cm. Eruptions appear on the face, tummy and can spread throughout the body. Vesicles can appear in the oral cavity and on the genitals. After the opening of the vesicles, very painful erosions remain, which after a couple of days are covered with a crust. And the healing process is going on.
In case of pemphigus, newborn babies lose appetite, refuse breastfeeding, and then weight can decrease. There is weakness, raising the temperature to high levels, there is concern.
It is possible to distinguish three stages of the flow of pemphigus of newborns: erythematous, exfoliative and regenerative. Erythema from Latin translate as redness of the skin. At this stage, the skin changes in color, inflammation occurs and rashes appear. Exfoliation translates as exfoliation, exfoliation. Rashes form a liquid, the surface epithelium is broken, a bubble burst. At this time, there is a positive symptom of Nikolsky: the friction exfoliates the surface layer of the epithelium. The epithelium also peels off when sipping at the edge of the bladder. At the regenerative stage, erosion is healed. Formed crusts, which eventually move away from the skin.
In benign pemphigus of newborns, only certain parts of the body are affected: pens, legs, tummy, groin, neck, chest, back. Rashes are quite rare, single and small in size. Body temperature does not rise above 38 ° C. Sometimes the general condition of the infant is not disturbed at all. The child completely recovers in 2-3 weeks.
In the malignant form of the pemphigus of newborns, the whole body of the infant can be affected, the rashes are multiple and can reach 3 cm. After opening the blisters, large and very painful erosions form. The epithelium between the blisters is broken and peels off after rubbing. Also exfoliate the skin, if you pull the edge of the bubble. A high temperature is observed, above 38 ° C.This form of the disease is very severe. There is an intoxication of the body and its symptoms are temperature, weakness, refusal to eat, nausea, diarrhea, vomiting. A sick child may experience septicemia and sepsis. Recuperation comes in a month.
There are following forms of malignant pemphigus: syphilitic pemphigus of newborns, staphylococcal and epidemic.
Staphylococcal pemphigus of newborns is the most common. Staphylococcus is the causative agent. The epidemic form of the disease is also caused by staphylococcus aureus. The name comes from the fact that this form of the disease can cause an epidemic - a rapidly spreading disease. Children with this disease must be isolated from others, becauseThe disease is extremely contagious.
Syphilitic pemphigus of newborns is a sign of syphilitic disease, that is syphilis. The causative agent is pale treponema. Infection of the child occurs in the prenatal period from a sick mother. The peculiarity of this type of pemphigus of newborns is the rich color of copper-red skin, the bubbles also occur with red contents with the content of the pathogen, the localization of lesions on the soles and palms. Can appear scars are characteristic only for syphilis. This type of disease is the most difficult and dangerous.
Newborn babies: diagnosis
Epidemic pemphigus of newborns is easily diagnosed, but difficult to treat. To determine the correct diagnosis, all factors of the disease are taken into account. It takes into account the time of the violation of the state of the newborn, the time the occurrence of rashes, behavior. The cause of pemphigus, the possibility of contact of the child with a sick person is established. It is necessary to clarify whether the mother or the medical staff was ill for any skin diseases. Next, a general external examination of the baby, determine the nature and appearance of the elements of the lesion. If the disease has passed into the exfoliative stage, the doctor conducts a local examination of lesions, checks the symptom of Nikolsky( with the friction of apparently healthy areas between the blisters, the skin exfoliates).If the symptom is positive, this gives grounds to diagnose a newborn baby with pemphigus.
To identify the pathogen, determine the type of pemphigus correctly and choose the treatment, the fluid is sown from the lesion. Based on the results of the study, an antibiotic sensitive to this microflora is selected. To exclude syphilitic pancreatitis, microscopy is performed, a PCR test. In the presence of pale treponema, the syphilitic pemphigus of a newborn is diagnosed. It is also mandatory to conduct a clinical blood test, which determines how much inflammation in the body of the baby( by the number of leukocytes and ESR).With the help of the same analysis, it is determined whether there was a complication, sepsis.
Differential diagnosis of pemphigus of newborns is carried out with such diseases as herpes, chickenpox, congenital syphilis, congenital epidermolysis, desquamative erythroderma of Leiner, ichthyosiform erythroderma, bullous and other forms of dermatitis, as well as with allergic reactions. Obligatory consultation of a dermatovenereologist and infectious disease specialist is required. It is recommended to consult a neonatologist.
Newborn babies: treatment
Staphylococcal pemphigus of newborns is treated in the hospital, it is necessary to isolate the sick child from other children. In the care of the newborn, patients with pemphigus, strictly adhere to the rules of hygiene, use only sterile underwear and tools, spend quartzing every 4-5 hours. Bathing the baby is done with the addition of antiseptic solutions and decoctions of herbs( celandine, chamomile, oak bark) into the water. Daily change of linen is necessary. Rashes are treated with ointments and aerosols with antibiotics. Antiseptics - Iodine, Brilliant green or Methylene blue are also used. At the stage of rupture of blisters, children's powder with Xeroform is used to dry the elements of the lesion. Untreated skin is treated with salicylic alcohol to prevent the spread of infection.
The most basic therapy for the treatment of pemphigus of newborns is the use of antibiotics of the penicillin or cephalosporin series( Amoxicillin, Cefazolin, Cephalexin, Cefoksitin).It is advisable to give preference to antibiotics 1 or 2 generations, so as not to develop a baby's immunity to stronger antibiotics. When choosing an antibiotic, a test for sensitivity to a particular medicine must be taken into account.
In the treatment of pemphigus of newborns, antistaphylococcal plasma, antistaphylococcal gamma globulin is also administered. After the application of antibiotics, the administration of probiotics for the restoration of microflora must be prescribed - Lineks, Bifiform, Lactobacterin.
For malignant pemphigus for detoxification, infusion therapy is performed - drip medications and solutions are added to replenish body fluid volumes. Apply physiological saline, Hemodez, Polyglukin, glucose solution. Also carry out symptomatic treatment. At a temperature, antipyretic agents are used. In malignant form of the disease with large lesions, anesthetics are used. With this form of the disease, sepsis, septicopyemia may occur. In this case, increase the dose of antibiotic, carry out massive infusion therapy, transfuse blood plasma. Be sure to carry out treatment to improve the immunity of the newborn.
With malignant form of pemphigus there are complications: abscess, otitis media, pharyngitis, pneumonia, pyelonephritis, omphalitis, sepsis. For the prevention of pemphigus in a baby, it is necessary to diagnose the disease in time and select a complex treatment. The prognosis is favorable, depends on the child's immune protection, the prevalence of the process, the treatment. There have been deaths from staphylococcal pancreatitis of newborns before the appearance of antibiotics.
The neonatal bladder does not have specific prevention, you need to take all measures to prevent the disease. This identification and treatment of diseases of the future mother, adherence to personal hygiene rules, adherence to proper care for the baby, it is required to exclude the contact of the child with the allegedly sick people. Workers of hospitals and maternity hospitals need to carefully process linens and tools, carry out quartz work on the schedule, conduct timely wet cleaning, isolate sick children, exclude sources of infection among medical personnel.
