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Impetigo Neonatorum


Presentation

  • We present a case of nonbullous impetigo neonatorum associated with late onset group B streptococcal meningitis in a 12-day-old infant. Both skin lesions and meningitis resolved with antibiotic therapy.[ncbi.nlm.nih.gov]
  • I shall discuss only the cases of bullous impetigo in which the bullae were definitely present on the infant at birth and not those in which the bullae developed after delivery.[jamanetwork.com]
  • The lesions are more common in moist, warm areas such as the axillary folds of the neck or the groin and present as superficial bullae which are wrinkled, become flaccid, and rupture easily producing ulcers which become crusted.[rrnursingschool.biz]
  • Investigations Swab for Gram stain (slide) and culture if discharge present FBE blood culture if systemic systemic symptoms present. Low yield.[rch.org.au]
Fever
  • The mother developed fever 24 hours postpartum, and Staphylococcus aureus was cultured from the episiotomy.[rrnursingschool.biz]
  • Constitutional symptoms are common which include: fever, cachexia, diarrhea with green stools that may lead to severe dehydration. Bacteremia, nephritis, pneumonia, lung abscess, meningitis are severe and may be fatal complications.[impetigo-treatment.learnandenjoy.com]
  • A rare pyoderma occurring most commonly in pregnant women as an eruption of small, closely aggregated pustules accompanied by fever and fatigue. Impetigo vulgaris impetigo vulgaris impetigo vul·gar·is (vŭl-gâr’ĭs) n. See impetigo.[definithing.com]
  • Term mild febrile disease w/ diffuse punctuate and maculopapular rash (resembles measles or scarlet fever) (milder than measles, rash starts at the face and spreads down); in children, no constitutional symptoms; in adults, Fever, Headache, coryza, Malaise[flashcardmachine.com]
  • Children's paracetamol can bring down a fever.[nhs.uk]
Constitutional Symptom
  • […] der·ma·ti·tis ex·fo·li·a·ti·va in·fan·tum, dermatitis exfoliativa neonatorum a generalized pyoderma accompanied by exfoliative dermatitis, with constitutional symptoms, affecting young infants, which may result from atopic dermatitis, Leiner disease,[medical-dictionary.thefreedictionary.com]
  • Dermatitis exfoliativa neonatorum, a generalised pyoderma accompanied by exfoliative dermatitis, with constitutional symptoms, affecting young infants, which may result from atopic dermatitis, Leiner's disease or staphylococcal scalded skin syndrome.[encyclo.co.uk]
  • Search dictionary help impetigo neonatorum -- dermatitis exfoliativa infantum medical dictionary Dermatitis exfoliativa neonatorum, a generalised pyoderma accompanied by exfoliative dermatitis, with constitutional symptoms, affecting young infants, which[mondofacto.com]
Fatigue
  • A rare pyoderma occurring most commonly in pregnant women as an eruption of small, closely aggregated pustules accompanied by fever and fatigue. Impetigo vulgaris impetigo vulgaris impetigo vul·gar·is (vŭl-gâr’ĭs) n. See impetigo.[definithing.com]
Dyspnea
  • Browse recently published Learning/CME Learning/CME View all learning/CME CME A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis Case 10-2019: A 69-Year-Old Man with Progressive Dyspnea Mucinous Ovarian Carcinoma Challenge Yourself Interactive[nejm.org]
Green Stools
  • Constitutional symptoms are common which include: fever, cachexia, diarrhea with green stools that may lead to severe dehydration. Bacteremia, nephritis, pneumonia, lung abscess, meningitis are severe and may be fatal complications.[impetigo-treatment.learnandenjoy.com]
Hematochezia
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
Cutaneous Manifestation
  • The cutaneous manifestations of human parvovirus B19 infection. Hum Pathol 2000;31:488-97. 32. Dunkle LM, Arvin AM, Whitley RJ, et al. A controlled trial of acyclovir... ‎ Seite 44 - Van AC. Acne update: 2004. Curr Opin Pediatr 2004;16:385.[books.google.de]
  • The cutaneous manifestations of human parvovirus B19 infection. Hum Pathol 2000;31:488-97. 32. Dunkle LM, Arvin AM, Whitley RJ, et al. A controlled trial of acyclovir... ‏ الصفحة 44 - Van AC. Acne update: 2004. Curr Opin Pediatr 2004;16:385.[books.google.com]
  • manifestation, which typically presents with macules that progress via a necrotising vasculitis to form indurated necrotic ulcers with surrounding erythema. [27,28] Prematurity, immune deficiencies, and neutropaenia are the main predisposing factors,[amsj.org]
  • The cutaneous manifestations and common mimickers of physical child abuse. J Pediatr Health Care. 2004;18:123–9. Copyright 2007 by the American Academy of Family Physicians. This content is owned by the AAFP.[aafp.org]
Pustular Rash
  • rash for 2 d.[docksci.com]
  • Physicians & health care workers attending to children in tropical countries should have a high index of suspicion for cutaneous myiasis in all cases of generalized pustular rash or furunculosis not responding to conventional antibiotics treatment, particularly[m.scirp.org]
  • Abstract An otherwise healthy, full-term neonate presented at day 15 of life to the pediatric emergency with generalized papulo-pustular rash for 2 d. This was finally diagnosed as bullous impetigo caused by Staphylococcus aureus ( S. aureus ).[ncbi.nlm.nih.gov]
Exanthema
  • The patient aged four years and six months was admitted to our clinic to establish the aetiology and treatment of a generalized bullous exanthema, followed by a skin denudation associated with fever and impaired general status.[jccm.ro]
  • The differential diagnosis included varicella-zoster, other viral exanthema, impetigo, folliculitis, infantile seborrheic dermatitis, and Letterer-Siwe disease. [2] A type IV hypersensitivity reaction to the mite, its eggs, or its feces develops in the[jcnonweb.com]
Agalactia
  • Authors Source MeSH Humans Impetigo Infant, Newborn Infant, Newborn, Diseases Male Skin Diseases, Vesiculobullous Streptococcal Infections Streptococcus agalactiae Pub Type(s) Case Reports English Abstract Journal Article Language ger PubMed ID 7008460[unboundmedicine.com]
  • Key words : Streptococcus agalactiae, infection, newborn Introduction Streptococcus agalactiae, also called Group B Streptococcus (GBS), can cause early- and late-onset infections in neonates.[signavitae.com]

Workup

  • "Acute Poststreptococcal Glomerulonephritis Workup: Approach Considerations, Hematologic and Blood Chemistry Studies, Urine Studies" . emedicine.medscape.com . Retrieved 2015-10-31 . Rodriguez-Iturbe, Bernardo; Musser, James M. (2008-10-01).[en.wikipedia.org]
  • When MRSA is suspected In the presence of an impetigo outbreak In the presence of poststreptococcal glomerulonephritis (PSGN); in such cases, urinalysis is also necessary Biopsy may be appropriate in doubtful or refractory cases of impetigo. [6] See Workup[emedicine.medscape.com]
Human Parvovirus B19
  • The cutaneous manifestations of human parvovirus B19 infection. Hum Pathol 2000;31:488-97. 32. Dunkle LM, Arvin AM, Whitley RJ, et al. A controlled trial of acyclovir... ‎ Seite 44 - Van AC. Acne update: 2004. Curr Opin Pediatr 2004;16:385.[books.google.de]
  • The cutaneous manifestations of human parvovirus B19 infection. Hum Pathol 2000;31:488-97. 32. Dunkle LM, Arvin AM, Whitley RJ, et al. A controlled trial of acyclovir... ‏ الصفحة 44 - Van AC. Acne update: 2004. Curr Opin Pediatr 2004;16:385.[books.google.com]

Treatment

  • Systemic treatment with erythromycin or flucloxacillin is required urgently. The patient should be isolated from other infants until fully recovered.[gpnotebook.co.uk]
  • Impetigo neonatarum Treatment: Drying of the exudate by potassium permanganate 1: 9000 in the form of wet compresses and application of topical anti bacterial cream such as Muperacin (Bactropan cream).[impetigo-treatment.learnandenjoy.com]
  • Stay at the forefront of your field with updated treatment methods throughout, as well as an increased focus on patients with skin of color.[books.google.de]
  • We feel that it is worth recording because the method materially simplified the treatment and technics in the nursery of newly born infants.[jamanetwork.com]

Prognosis

  • , distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis, and additional useful information HERE.[dovemed.com]
  • Prognosis [ 2 ] Full resolution is expected within two weeks of onset. 11% of patients develop a recurrence six weeks later.[patient.info]
  • Keywords: Impetigo, NVC-422, Clinical Phase 2, Staphylococcus, Streptococcus, MRSA Pub Med Prognosis of Impetigo Because impetigo responds rapidly to antibiotic therapy, the prognosis is excellent although it can reoccur.[lymphedemapeople.com]
  • Prognosis Generally good. The problem can be self-limiting, but will usually spread and persist on the skin if left untreated, which will represent a source of infection for others.[nursinginpractice.com]
  • Prognosis Complete resolution in 7–10 days with treatment Antibiotic treatment will not prevent or halt glomerulonephritis, as it will rheumatic fever. If not clear within 7–10 days, culture is necessary to find resistant organism.[tipsdiscover.com]

Etiology

  • ., macule, papule, vesicle, or pustule ), the layer involved (Figure), and the microbial etiology.[microbiologybook.org]
  • Etiology and Pathophysiology Coagulase-positive staphylococci: pure culture 50–90%; more contagious via contact β -Hemolytic streptococci: pure culture only 10% of the time (primarily group A) Mixed infections of streptococci and staphylococci are common[unboundmedicine.com]
  • Impetigo: etiology and therapy. Curr Clini Top Infect Dis. 2002;22:42-51. Koning S, van der Sande R, Verhagen AP, et al. Interventions for impetigo. Cochrane Database Syst Rev. 2012;1:CD003261. Johnston GA.[ebmedicine.net]
  • Etiology The etiology of the condition remains unknown. It has at times been postulated to be allergic, infectious, or hematologic in origin.[neurologyadvisor.com]
  • Presently, there are several unproven etiological hypotheses, including skin reaction to absorbed enterotoxines, hence the name “toxicum,” an allergic reaction due to eosinophilia in the lesions (and in the peripheral blood of some patients); however,[healthzene.com]

Epidemiology

  • Infection Control & Hospital Epidemiology ISSN: 0899-823X EISSN: 1559-6834 URL: /core/journals/infection-control-and-hospital-epidemiology[cambridge.org]
  • Epidemiology, treatment, and prevention of community-acquired methicillin-resistant Staphylococcus aureus infections. Mayo Clin Proc. 2005;80:1201–7; quiz 1208.[tipsdiscover.com]
  • […] affected; Folliculitis: considered by some to be S. aureus impetigo of hair follicles Ecthyma: a deeper, ulcerated impetigo infection often with lymphadenitis System(s) affected: skin/exocrine Synonym(s): pyoderma; impetigo contagiosa; impetigo vulgaris Epidemiology[unboundmedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • [ edit ] The pathophysiology of this disorder is consistent with an immune -complex-mediated mechanism, a type III hypersensitivity reaction .[en.wikipedia.org]
  • Etiology and Pathophysiology Coagulase-positive staphylococci: pure culture 50–90%; more contagious via contact β -Hemolytic streptococci: pure culture only 10% of the time (primarily group A) Mixed infections of streptococci and staphylococci are common[unboundmedicine.com]
  • Pathophysiology The condition has been known throughout the ages and was described by ancient Mesopotamian physicians [ 2 ].[patient.info]
  • Impetigo is more common in the warm summer months and among children living in crowded conditions.(2) [[nip35_fig1_20]] Photos courtesy of D@nderm Pathophysiology Impetigo is very contagious and spreads easily by direct physical contact.[nursinginpractice.com]
  • There is a possible etiological association of early-onset GBS sepsis with a late presentation of right-sided diaphragmatic hernia in infants, although the pathophysiological mechanism is not yet clear.[signavitae.com]

Prevention

  • Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization[books.google.de]
  • Special care and special precautions in nurseries are important in order to prevent spread of infection.[impetigo-treatment.learnandenjoy.com]
  • Treatable - 66% Emergent - ED Care Needed - Preventable/Avoidable - 34% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary[medicbind.com]
  • Epidemiology, treatment, and prevention of community-acquired methicillin-resistant Staphylococcus aureus infections. Mayo Clin Proc. 2005;80:1201–7; quiz 1208.[tipsdiscover.com]

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