1. Can SSSS recur?
Yes
2. Is SSSS contagious?
Yes, the staphylococci are spread primarily from person to person (familial clusters have been reported), even from mother to fetus, most efficiently by someone with lesions, but asymptomatic carriers may also spread infection. Spread of organisms does not necessarily lead to signs of toxin production in those acquiring infection.
3. How can one distinguish TEN from SSSS?
TEN is frequently confused with SSSS and may be differentiated by skin biopsy showing cleavage plane at the dermal–epidermal junction. TEN or Lyell disease is more common in adults and is usually secondary to drug hypersensitivity (e.g., sulfonamides, barbiturates, pyrazolone derivatives).
4. Can Staphylococcus be isolated from the bullae?
SSSS bullae are sterile, although organisms may be found in a distant focus, such as the nares or conjunctivae. In bullous impetigo, staphylococci may be isolated from the bullae.
(Modified from 5-Minute Pediatric Consult book)