Impetigo is considered as a benign and highly contagious skin infection affecting the epidermis appearing everywhere on the body. Usually it occurs in exposed areas like the nose, mouth, arms, and legs.
Characteristic yellow crusted lesions which are most commonly found on the face, typically there are also scattered surrounding lesions called satellite lesions. This starts out as vesicular lesions that are rarely painful. A less common form is bullous impetigo which is presented by larger blisters occurring on the trunk or diaper area of children. Ecthyma is more serious form of impetigo that penetrates deeply into skin causing painful collection of fluid or pus filled sores that turn into deep ulcers.
Entire Body System
Rheumatic fever Group A streptococcal skin infections have rarely been linked to cases of rheumatic fever and rheumatic heart disease. [dermnetnz.org]
Patients may experience fever, hypertension, edema and hematuria. [ncbi.nlm.nih.gov]
Symptoms of fever and swollen glands are more common in cases of bullous impetigo. [nhsinform.scot]
Symptoms of severe impetigo infection If large areas of the skin are affected, symptoms may also include: fever swollen lymph glands general feeling of unwellness (malaise). [web.archive.org]
There is weak evidence for the superiority of topical antibiotics over some oral antibiotics, such as erythromycin (OR = 0.48, 95% CI = 0.23 to 1.00). [ncbi.nlm.nih.gov]
Don't try over-the-counter antibacterial ointments; they are too weak to kill strep and staph infections, and applying the ointment carelessly may actually spread the impetigo. [webmd.com]
Sports requiring skin-to-skin contact, having a weak immune system, or having a chronic skin problem such as eczema can also increase your child's risk of getting impetigo. [skinsight.com]
If this happens, your child may have fever, pain, swelling, and may feel weak. How is it passed? Direct contact : Impetigo can spread when someone touches an impetigo rash. [caringforkids.cps.ca]
The anti-streptolysin O response is weak in patients with streptococcal impetigo, presumably because skin lipids suppress streptolysin O response, but anti-DNAase B levels are consistently elevated. [symptoma.com]
Patients with IgM deficiency may present with a wide spectrum of clinical manifestations, from asymptomatic to life-threatening infections, including recurrent respiratory and gastrointestinal infections, allergy and autoimmunity. [ncbi.nlm.nih.gov]
For patients with recurrent impetigo, asymptomatic family members and S. aureus nasal carriers, try measures to reduce colonisation of the nose and spread, such as the use of Naseptin®. [patient.info]
Nasal swabs from the patient’s immediate family members are necessary to identify them as being asymptomatic nasal carriers of S. aureus. [en.wikipedia.org]
With neonatal impetigo, also evaluate hospital nursery staff and household members for pyodermas or asymptomatic bacterial carrier states. Failure to treat other infected persons may result in continued transmission. [emedicine.medscape.com]
- Severe Pain
See the doctor immediately for moderate-to-severe infection or if your child has a fever or severe pain. If your child is currently being treated for a skin infection that has not improved after 2–3 days of antibiotics, return to the child's doctor. [skinsight.com]
The presence of symptoms such as fever, severe pain, worsening redness and swelling, or loss of appetite suggests a more serious type of infection. If you have these types of symptoms, discuss them with your healthcare provider. [uptodate.com]
- Nasal Discharge
Impetigo can spread by contact with sores or nasal discharge from an infected person. You can treat impetigo with antibiotics. 684 Impetigo convert 684 to ICD-10-CM [icd9data.com]
Impetigo can spread by contact with sores or nasal discharge from an infected person. You can treat impetigo with antibiotics. NIH: National Institute of Allergy and Infectious Diseases [medlineplus.gov]
Impetigo can spread by contact with sores or nasal discharge from an infected person. You can treat impetigo with antibiotics. [icd10data.com]
Impetigo can be spread by coming into contact with the sores or any mucus/nasal discharge from someone who is infected. [my.clevelandclinic.org]
In this situation, skin integrity is often disrupted by the continuous covering of purulent nasal discharge. Adults often develop impetigo from close contact with infected children. [rxlist.com]
It usually starts with reddish spots that develop into small red blisters around the mouth and nose. The blisters range in size from 1 to 2 centimeters in diameter (.39 to .78 inch) ( 9 ). The clusters of blisters may spread to other skin areas. [healthline.com]
PubMed was used to search the following terms, separately and in combination: blister, blistering, bullous, gestationis, herpes, herpetiformis, impetigo, pemphigoid, pregnancy, pregnant, psoriasis, pustular, virus. [ncbi.nlm.nih.gov]
Blisters usually appear first on the torso, arms, and legs. These blisters may initially appear clear and then turn cloudy. Blisters caused by bullous impetigo tend to last longer than blisters caused by other types of impetigo. [web.archive.org]
In infants, the skin is reddish or raw-looking where a blister has broken. Blisters that itch, are filled with yellow or honey-colored fluid, and ooze and crust over. [nlm.nih.gov]
- Insect Bite
It usually starts when bacteria get into a break in the skin, such as a cut, scratch or insect bite. Symptoms start with red or pimple-like sores surrounded by red skin. [icd9data.com]
Examples are a scratch or insect bite. The most common bacteria are Staph and Strep. If the child has a sore throat, they may also have Strep throat. A rapid Strep test will give the answer. [stlouischildrens.org]
Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas. [ncbi.nlm.nih.gov]
Bacteria gets in under the skin through small cuts, scratches or insect bites. [uvahealth.com]
It's important to wash cuts, scrapes, insect bites and other wounds right away. To help prevent impetigo from spreading to others: Gently wash the affected areas with mild soap and running water and then cover lightly with gauze. [web.archive.org]
Atopic eczema is a common risk factor; others include bites, trauma to the skin, scabies, chickenpox, burns and contact dermatitis. [patient.info]
Other people also read: Eczema : the symptoms. Atopic dermatitis : features of atopic eczema. Diabetics : what causes diabetes? Last updated 13.01.2014 [netdoctor.co.uk]
Possible causes of symptoms Skin symptoms Possible cause Blisters on lips or around the mouth Cold sores Itchy, dry, cracked, sore Eczema Itchy blisters Shingles, chickenpox Non-urgent advice: See a GP if you or your child: might have impetigo had treatment [nhs.uk]
Especially at the early stage of the infection, diagnosis is difficult because it is often misdiagnosed as eczema. We report a case of T. tonsurans infection that had impetigo-like appearance. We also studied the mechanism of the disease. [ncbi.nlm.nih.gov]
Symptoms of eczema include: red, itchy skin dry skin One type called dyshidrotic eczema causes tiny fluid-filled blisters to form on your hands or feet. These blisters may itch or hurt. People who have allergies are more likely to get eczema. [healthline.com]
- Honey-Colored Crust
The bullae burst and expose larger bases, which become covered with honey-colored varnish or crust. Ecthyma is characterized by small, purulent, shallow, punched-out ulcers with thick, brown-black crusts and surrounding erythema. [merckmanuals.com]
The blisters burst and expose raw skin, which becomes covered with honey-colored crust. Ecthyma is characterized by small, shallow ulcers that have a punched-out appearance and sometimes contain pus. [msdmanuals.com]
After several days, the blisters and pustules rupture and weep, forming the classic honey-colored crusts. [innerbody.com]
Ecthyma is characterized by small, purulent, shallow, punched-out ulcers with thick, brown-black crusts and surrounding erythema. Impetigo and ecthyma cause mild pain or discomfort. [merckmanuals.com]
A doctor's evaluation Doctors base the diagnosis of impetigo and ecthyma on the appearance of the rash. [msdmanuals.com]
Diagnosis is mainly by clinical examination by a dermatologist. Assays of streptococcal antibodies are of no value in the diagnosis and treatment of impetigo, but they provide helpful supporting evidence of recent streptococcal infection in patients suspected of having post-streptococcal glomerulonephritis. The anti-streptolysin O response is weak in patients with streptococcal impetigo, presumably because skin lipids suppress streptolysin O response, but anti-DNAase B levels are consistently elevated.
Generally, the clinical course and treatment of impetigo depends on many factors including number of lesions, location of lesions, and the urgent need to limit spread of infection to other households or other persons in contact. If the case is presented only by small localized lesions, topical antibacterials like hydrogen peroxide and mupirocin ointments may be used for up to two weeks. In patients who do not respond to topical therapy, or those with impetigous lesions spreading in larger areas, lymphoedematous conditions or systemic illness oral antibiotics may be used like oral Flucloxacillin 500 mg four times daily for 7 days.
Other alternatives include Cephalexin 25 mg/kg/day in 4 divided doses for childeren. If patient is allergic to penicillins Erythromycin (which was in past the mainstay of pyoderma treatment) may be used. Clindamycin is generally effective treatment for skin bacterial infections including impetigo. If there is no response to treatment, courses of topical antibiotics should not be repeated. Instead, swabs to exclude resistant organisms should be done and proper therapy for underlying sensitive strains considered . In severe cases, intravenous antibiotics may be used to treat and control the spread of impetigo .
Impetigo may be self-limiting within two to three weeks, but antibiotics can shorten the course of the disease and help prevent the spread to others . Superficial crusts and blisters of impetigo usually do not leave scars. Red skin lesions last for weeks, but redness fades within days to weeks.
Suppurative lesions from streptococcal impetigo are not a common complication. One potentially serious, but rare (only in 1% of cases) complication of impetigo caused by streptococcus bacteria is acute glomerulonephritis and rheumatic fever . The ulcerative scarring which is associated with a deeper and more serious form of impetigo (e.g. ecthyma) can leave permanent scars.
It is commonly caused by beta hemolytic streptococci and/or Staphylococcus aureus. These are the usual microorganisms that colonize the unbroken skin. These gram positive strains are often times easily treatable, but impetigo may also be caused by methicillin-resistant and gentamycin-resistant strains of Staphylococcus aureus .
Impetigo is common through the world but it is most frequent among children in the lower economic strata in tropical or subtropical regions. The disorder is also seen to be prevalent in northern regions during the summer and fall months . Its peak incidence is among children with age two to five years, although older children and adults may also be afflicted. There is no sex predilection, and all races are susceptible. Impetigo infections are more common in summer. Participation in sports that involve skin to skin contact, such as football and wrestling increases your risk of developing impetigo. The causative bacteria often enter the skin through a small skin injury, insect bites or rash. The international mean incidence of impetigo is 10-22 cases per 1000 population per year depending on the geographic location . Older adults and people with diabetes or a compromised immune system are more likely to develop ecthyma which is a deeper and more serious form of impetigo that usually leaves scars.
Research studies of streptococcal impetigo have elucidated that the causative microorganisms initially colonize the intact skin; thus, proper personal hygiene can directly subdue the disease incidence. Inoculation of surface organisms into the skin by abrasions, minor trauma, or insect bites (pediculosis) then ensues . During the course of two to three weeks, streptococcal strains may be transferred from the skin and impetigo lesions to the upper respiratory tract. In contrast, in patients with staphylococcal impetigo, the pathogens are usually present in the nose before causing cutaneous disease.
Bullous impetigo is caused by strains of Staphylococcus aureus that produce a toxin causing cleavage in the superficial layers of skin. In past, non bullous lesions were usually caused by streptococci. Now, most cases of impetigo are caused by staphylococci alone or in combination with streptococci. Streptococci isolated from lesions are primarily group A organisms, but occasionally, other serogroups (such as C and G) are responsible.
Wash your hands or hands of your child after touching patches of impetigo. Usage of towels, flannels, and other fomites should be personal until the infection is eradicated. Children with impetigo should stay off school until there is no crusting.
Impetigo is considered the most common bacterial skin infection in children. It may appear primarily or may occur as a secondary bacterial infection on abrasions and lacerations of the skin . Impetigo usually resolves in 2-3 weeks but the use of antibiotics can shorten its course and prevent it from spreading. It may occur as bullous and non-bullous forms and 70% of these cases are in non-bullous forms especially in the pediatric age group .
Impetigo is a benign and highly contagious skin infection affecting epidermis appearing everywhere on the body, but usually occurs in exposed areas like the nose, mouth, arms, and legs.
Non-tender vesicular lesions that progresses to crusting lesions that’s spreads in the epidermis are the typical symptom.
Diagnosis is by mean of direct physical examination of the skin surface.
Treatment and follow-up
Topical hydrogen peroxide, mupirocin, clindamycin and bacitracin. Intravenous and oral antibiotics may be taken to prevent the aggressive spread of the infection.
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