Skin infection is a general term referring to the invasion and multiplication of pathogens within the patient's epidermis, dermis and/or skin appendages. Causative agents may or may not be part of the physiological skin flora.
Owing to the wide variety of possible causes, skin infections clinically present in a heterogenous manner and only few aspects can be generalized: Usually, a skin infection triggers an immune response, and the interactions between the causative pathogens and the patient's immune system result in an inflammation. The latter is characterized by the five cardinal signs of inflammation, i.e., by calor, dolor, rubor, tumor and functio laesa. Additionally, molecules released by microorganisms or the body's own immune cells may mediate systemic effects. Moderate to severe skin infections may thus be associated with fever, chills, hypotension and tachycardia. Streptococcus pyogenes is very likely to induce such systemic symptoms, which is reflected in its name.
Entire Body System
RESULTS: At baseline, lesion size did not correlate with pain intensity: r=0.02 for VAS and r 0.95). [ncbi.nlm.nih.gov]
I heard that the pain can continue even though the skin eruption has healed. Is this true? Yes. Unfortunately, some people with shingles may suffer from prolonged pain even after the skin lesions have resolved. [dermatology.org.sg]
Nerve pain due to shingles can sometimes persist for weeks to years after the rash heals. This painful, post viral condition is known as post-herpetic neuralgia. [emedicinehealth.com]
Puerperal fever c. Surgical scarlet fever d. Myositis e. Necrotizing fasciitis 2. Localized a. Impetigo b. Ecthyma - hardbase c. Hidradenitis The above may be antecedent to acute glomerulonephritis. [atsu.edu]
After 3 days on penicillin, the fever decreased, but the dermatitis became incapacitating. On his return to shore, the fisherman was hospitalised. [ncbi.nlm.nih.gov]
Salmonella species, particularly S typhi ( typhoid fever ) Aeromonas species, found in water, rarely cause skin and soft tissue infections Tick -borne bacterial infections include: Lyme disease, due to Borrelia burgdorferi Relapsing fever, due to Babesia [dermnetnz.org]
Seek Medical Care If Your Child: has an apparent skin infection that is getting larger feels sick or has fever or chills has red streaks near the infected area Think Prevention! Wash hands well and often, especially after touching infected areas. [kidshealth.org]
Infection of the skin is distinguished from dermatitis, which is inflammation of the skin, but a skin infection can result in skin inflammation. [en.wikipedia.org]
However, the molecular mechanisms that orchestrate initiation and termination of inflammation in skin infection are incompletely understood. [ncbi.nlm.nih.gov]
When this happens, inflammation can occur. Like any other part of your body, your skin can be involved in immune responses. Inflammation in the skin often causes a rash to form. [healthline.com]
Purulent inflammation of hair follicles and development of small abscesses characterize furunculosis. [symptoma.com]
- Streptococcal Infection
Systemic administration of penicillins, or erythromycin or a tetracycline in penicillin-sensitive individuals, is effective in streptococcal infections. [apps.who.int]
Scarlet fever may accompany streptococcal pyoderma or wound infection (surgical scarlet fever). Transient lymphadenitis occurs, and significant regional lymphadenopathy is characteristic of streptococcal impetigo. [atsu.edu]
However, because the lesions of bullous impetigo can be large and both forms of impetigo can have satellite lesions, an oral antibiotic with activity against S. aureus and group A beta-hemolytic streptococcal infection is warranted in nonlocalized cases [aafp.org]
Streptococcal infection is usually characterised by acute onset of rapidly spreading erythema, lymphangitis and lymphadenopathy. Staphylococcal cellulitis is usually associated with purulent lesions with erythema. [nps.org.au]
- High Fever
fever > 38C Swab of inflamed site, eg, throat, skin lesions for culture. [dermnetnz.org]
There is a high prevalence of purulent skin infections caused by community-acquired (non multiresistant) methicillin-resistant Staphylococcus aureus. [nps.org.au]
It usually develops suddenly with: A high fever Nausea and vomiting A rash on your palms and soles that resembles sunburn Confusion Muscle aches Diarrhea Abdominal pain Septic arthritis Septic arthritis is often caused by a staph infection. [mayoclinic.org]
Cultures of a biopsy specimen and of aspirated seropurulent fluid in nodules showed acid-fast bacteria, identified as M. avium by the DNA-DNA hybridization method. [ncbi.nlm.nih.gov]
An aspirator attached to a faucet produces a modest vacuum when the water is turned on. A rubber tube from the aspirator is connected to the rotavaporator, reducing the pressure and causing the water to evaporate rather quickly without boiling it. [moringatrees.org]
If the patient has diabetes, an immunocompromising disease, or persistent inflammation, blood cultures or aspiration (some physicians inject sterile nonpreserved saline before aspiration) of the area of maximal inflammation may be useful. 2 – 4 For infection [aafp.org]
In some cases, even with nephrotic syndrome, and hypertension, especially in adults over 30 years (group 3), being the least frequent finding of gross hematuria, and rarely, acute renal failure. [ncbi.nlm.nih.gov]
Glomerulonephritis The major clinical and laboratory manifestations of acute post-streptococcal glomerulonephritis are: CLINICAL FEATURES LABORATORY FINDINGS Abrupt onset Hematuria, cylindruria Headache, malaise Proteinuria Edema, oliguria, dark urine Azotemia Hypertension [atsu.edu]
Presenting signs and symptoms of glomerulonephritis include edema and hypertension; about one third of patients have smoky or tea-colored urine. [aafp.org]
It usually develops suddenly with: A high fever Nausea and vomiting A rash on your palms and soles that resembles sunburn Confusion Muscle aches Diarrhea Abdominal pain Septic arthritis Septic arthritis is often caused by a staph infection. [mayoclinic.org]
Text Size Email Print Share Infections caused by staphylococcal organisms can lead to a variety of diseases, including pneumonia, abscesses, bone infection (osteomyelitis), joint infection (arthritis), and a number of skin infections (eg, impetigo, pimples [healthychildren.org]
Septic arthritis can also cause pain and inflammation in the spine, feet, ankles, hips, wrists, hands, elbows and shoulders. [draxe.com]
MARAZZI/SCIENCE PHOTO LIBRARY Sores (non-bullous impetigo) or blisters (bullous impetigo) can start anywhere – but usually on exposed areas like your face and hands Credit: SCIENCE PHOTO LIBRARY It's also common for blisters to start around your middle [nhs.uk]
If it is caused by staphylococcus, people will notice larger blisters that appear to contain a clear fluid. These blisters stay intact for a longer period of time compared to the smaller ones. [doctorsthatdo.org]
Herpes present itself as a fluid filled blister on top of red skin. Once the blister breaks open it appears with a crusty painful scab 2, 3. There is no cure for the herpes virus but treatments include Valtrex and prophylactic medications. [ghsa.net]
Symptoms include pus-filled blisters or pustules. Blisters can range in size from peas to large rings. There is often oozing honey-colored liquid and yellowish scabs. Impetigo tends to occur on the face, arms, or legs. [massgeneral.org]
Although there are many different types of skin infections, symptoms commonly include lesions, blisters, or sores. [orthoinfo.aaos.org]
[…] into the relative risk for atypical mycobacterial infections in the setting of eczema. [ncbi.nlm.nih.gov]
Controlling Eczema to Prevent Skin Infections Prevention is easier when eczema is under control. To help keep skin in good shape, follow these steps: Moisturize. Daily moisturizing is key. [everydayhealth.com]
Eczema is not contagious, which means you cannot give eczema to someone else and you cannot get eczema from someone else. Sometimes when the skin is red, weepy and blistered, it may become infected. [healthnavigator.org.nz]
Eczema also makes patients more susceptible to staph infections. [livescience.com]
AD was diagnosed and assessed according to the validated European Task Force on Atopic Dermatitis. DNA samples of patients were analyzed for allelic variants in the promoter and coding exon of FLG. [ncbi.nlm.nih.gov]
Skin rashes and irritations, or contact dermatitis, are common skin disorders caused by substances that irritate the skin or cause an allergic skin reaction. [walgreens.com]
[…] of moderate to severe Atopic Dermatitis. [centerwatch.com]
نحن نعالج الترجمة Allergic contact dermatitis is a form of contact dermatitis. It appears in the form of a rash and is the manifestation of an allergic response caused by contact with certain chemicals. [bumrungrad.com]
- Skin Disease
Concepts Disease or Syndrome ( T047 ) MSH D012874 SnomedCT 267839004, 156325001, 19824006, 108365000 English Disease, Infectious Skin, Diseases, Infectious Skin, Infectious Skin Disease, Infectious Skin Diseases, Skin Disease, Infectious, Skin Diseases [fpnotebook.com]
The result reveal that Skin Diseases Expert System has been successfully detecting skin diseases and displaying the result of identification process. Cite This Paper Andino Maseleno, Md. [doi.org]
A patient with skin infection due to Mycobacterium avium is reported. A 9-year-old female had 10 subcutaneous nodules and two ulcers on the abdomen and legs. She had no medical history of systemic disease, skin disease or immunosuppressive therapy. [ncbi.nlm.nih.gov]
Results: Prevalence rate of caregivers" skin diseases was 76.6%. Diagnosis of Skin disease was contact dermatitis 42.5%, scabies 26.9%, and skin xerosis 25.0%. The Mean RSI score was 3.81 and MP was 4.12. [dbpia.co.kr]
- Skin Lesion
A 42-year-old fisherman was first presented with skin lesions while fishing for hake. [ncbi.nlm.nih.gov]
The primary treatment of an abscess or purulent skin lesion (one discharging pus) is incision and drainage. [momsteam.com]
The SSA considers the following factors when assessing your Chronic Skin Infection Diagnosis: Skin Lesions. [disability-benefits-help.org]
David's North Medical Centre feared the infection could damage her sight and even spread to her brain. The blogger was treated with IV antibiotics, which managed to tackle the infection. [independent.ie]
Treatment ashore was advised because of difficulty in continuing manual work on board whilst suffering from significant skin lesions and also due to fear of contagion. [ncbi.nlm.nih.gov]
The fear of re-infection meant that a doctor could never stitch the wound shut. Instead he had to wait for the wound to close on its own, which only happened Wednesday, Turner said. [dailynews.com]
Staphylococcus (bottom) There are a lot of similarities between Streptococcus (Strep) and Staphylococcus (Staph) that lead to confusion. [mrsaidblog.com]
Due to its location and appearance, erythrasma is often confused with fungal infections such as athlete's foot and jock itch. [verywellhealth.com]
The CA_MRSA lesions have been confused with spider bites. CA-MRSA treatment An athlete with a suspected MRSA infection must be immediately isolated from other team members and referred to a knowledgeable physician. [momsteam.com]
“Many people confuse thirst and hunger,” says Gochnour. Never taking a break You’re on a workout kick or you’re full-on in training. Can’t stop, won’t stop. But guess what: You really gotta stop and put in some recovery days. [mensfitness.com]
[…] to suddenly become red, hot, swollen, painful and tender In more severe cases, cellulitis can also be accompanied – and often preceded – by: A high temperature (fever) of 38C (100.4F) or above Vigorous shaking (rigors) Nausea and vomiting Dizziness Confusion [dailymail.co.uk]
A 1-week-old infant was brought to a regional hospital with a history of recurrent seizures following lower abdominal septic skin infection. She was found to have neonatal tetanus, and a spatula test was positive. [ncbi.nlm.nih.gov]
with over‐applications and ingestions Preexisting seizure disorder No residual activity Infants and children under 6 months of age Increasing drug resistance Pregnancy Breast feeding 10% Crotamiton cream or lotion (Eurax) C Apply from neck down on two [doi.org]
Patients presenting with dermatological lesions should undergo a thorough general and dermatological examination. This approach does not only aim at clarifying whether a patient suffers from a skin infection or not, it may also allow to recognize signs indicating an underlying disease. As has been mentioned above, immunodeficient patients are at particularly high risks of contracting infectious diseases, and immunodeficiency may be caused by diseases as common as diabetes mellitus . The presence of primary disorders may also affect the choice of treatment .
In most cases, skin infections are diagnosed clinically. The patient's response to empirical treatment may then confirm this diagnosis, or indicate the need for further diagnostic measures. It is not generally recommended to delay treatment until the causative pathogen has been isolated and defined. In moderate to severe cases, however, representative specimens should be obtained before antimicrobials are administered. If they are tested for the presence of determined microorganisms, the respective results may already be available when a change of the therapeutic regimen is required. In detail, the following techniques may be applied:
- Gram staining and microscopic examination of samples
- Isolation of pathogens and evaluation of resistance to antimicrobials
- Serological tests
- Molecular biological tests like polymerase chain reaction
- Histopathological analysis of tissue samples
- Staphylococcus Aureus
More than 150 species of candida exist, according to the Centers for Disease Control and Prevention (CDC). However, the majority of infections are caused by a species called Candida albicans. [healthline.com]
Although several species of fungi are potentially pathogenic in humans, candida (esp. Candida albicans ) is the organism responsible for most fungal infections. Candida, which is normally present within the human body, is usually harmless. [lifeextension.com]
The ethanolic and aqueous extracts of Kheaw-Hom remedy and the aqueous extract of its plant ingredients had no activity against C. albicans but the ethanolic extract of Sophora exigua showed the highest activities against Candida albicans with MIC values [ncbi.nlm.nih.gov]
Coconut oil is also a popular remedy for fighting systemic (internal) Candida yeast infections, although its taken orally in such situations. [wikihow.com]
Candida (yeast) infections Candida is a yeast, which means it’s a kind of fungus. It may live harmlessly inside the gastrointestinal tract (gut) and vagina. [bupa.co.uk]
Treatment primarily aims at eliminating the causative pathogen, but appropriate wound care is also indicated. Either systemic and topical treatment may be indicated, depending on the extension of the dermatological lesion.
If a bacterial skin infection is suspected and an antibiogram is not yet available, antibiotics with known effectivity against Gram-positive, lactamase-resistant strains should be applied. Cephalosporins and fluoroquinolones are most frequently used, but bacteria may present with resistances to those compounds in certain geographic regions. Thus, knowledge about the local resistance situation is required to take this decision. Particular care has to be taken if a patient proves to be infected with methicillin-resistant Staphylococcus aureus. A total of more than twenty pharmacological agents are approved for the therapy of skin infections, with vancomycin, ceftaroline, tedizolid, dalbavancin, oritavancin, and telavancin being active against methicillin-resistant strains .
Infections with fungi are treated with antimycotics, e.g., with azoles like miconazole, ketoconazole, itraconazole or fluconazole, with terbinafine, or with amorolfine . Otherwise, recommendations are similar to those given above. Antifungal therapy may also be administered systemically or topically.
Some skin infections may require incision and drainage or even more extensive surgery.
The majority of skin infections are associated with a good to excellent prognosis, depending on the availability of proper medical attention. However, even well-treatable skin infections may considerable limit the patient's life quality. Pain, pruritus and psychological burden are only three examples for symptoms related to dermatological disorders that may interfere with carrying out everyday tasks and maintaining an active social life.
Few skin infections are life-threatening, e.g., the above mentioned staphylococcal scalded skin syndrome, but mortality may also be registered in patients suffering from seemingly uncomplicated infections with multiresistant pathogens.
Even under physiological conditions, many species of microorganisms colonize the human skin. Here, it is important to distinguish a colonization from an infection: A person does benefit from the presence of several microorganisms on their skin, while others are rather classified as commensals. The entirety of those microorganisms constitutes the physiological skin flora, and its composition varies depending on the precise area of skin in question, on endogenous host factors and exogenous environmental factors. In general, species pertaining to bacterial genres Corynebacterium, Propionibacterium and Staphylococcus are most abundant . With regards to fungi, Malassezia spp. dominate the microbiome. Little is known about viruses being part of the skin flora.
Moreover, the skin disposes of non-specific and specific defense mechanisms to prevent a skin infection. Keratinocytes, for instance, may release antimicrobial peptides and cytokines, namely defensins, histatins and cathelicidin as well as IL-1β, IL-6, IL-10 and TNF-α, among others   Some are released constitutively, others upon stimulation by microbial structures or pro-inflammatory cytokines.
In sum, for a skin infection to take place, one or more of the following conditions need to be fulfilled:
- Breakdown of physical barrier, e.g., in case of wounds
- Deficiency of non-specific or specific immunity
- Highly virulent pathogen or large infectious dose
A complete list of possible etiologic agents cannot be provided, but some examples shall be given:
- Staphylococcus aureus, including methicillin-resistant strains
- β-hemolytic Streptococcus spp.
- Dermatophytes like Trichophyton spp. and Microsporum canis
- Yeasts like Candida spp. and Malassezia spp.
- Herpes simplex virus and varicella zoster virus
- Human papillomavirus
- Molluscum contagiosum virus and other Poxviridae
In general, skin infections are very common and may affect men and women, people of all races and age groups. However, incidence, prevalence and distribution of determined skin infections vary significantly. Tinea pedis is a dermatophytic infection of interdigital areas of the foot, and the disease' prevalence has been reported to be about 3% in the general population and up to 60% in selected populations at high risks . Incidence rates increase with age and men are affected more often than women. Similarly high prevalence rates have been reported for impetigo, a disease caused by an infection with Gram-positive cocci: In Australia and Oceania, approximately 40% of the population show signs of impetigo . On the other hand, Staphylococcus aureus may induce staphylococcal scalded skin syndrome, a rare type of skin infection typically diagnosed in neonates and infants. This life-threatening disease only affects about 1 in 10,000,000 habitants per year .
The skin is composed of epidermis and dermis as well as skin appendages like sweat glands, sebaceous glands, hairs and nails. For pathogens to reach deeper layers of the skin, they need to overcome the epidermis. This is most easily done if the patient presents a cut or laceration, or an insect bite. However, the precise point of entry is not always traceable.
Distinct medical terms have been coined to describe skin infections that compromise its individual components, and those terms may already imply if an infection is mild or severe, if its acute or chronic. The following list shall serve as an orientation to this end:
- Impetigo is a superficial skin infection mainly diagnosed in pediatric patients. Staphylococcus aureus is the causative pathogen of bullous impetigo; β-hemolytic Streptococcus spp., mainly Streptococcus pyogenes, cause non-bullous impetigo.
- If not adequately cared for, impetigo may turn into ecthyma, a type of skin infection that extends into the dermal layer. Lesions are often covered by eschar-like indurated plaques. Development of ecthyma is frequently associated with occlusion of impetigo, poor general hygiene and immunodeficiency due to malnutrition.
- Erysipelas also refers to an infection of the upper layers of the skin, but this type of skin infection involves lesions of lymphatic vessels. It is most frequently caused by Streptococcus pyogenes, and other β-hemolytic Streptococcus spp. play minor roles in erysipelas etiology.
- Cellulitis refers to a poorly demarcated inflammation of the dermis and subcutaneous tissues, and pathogens usually enter through damaged skin. Of note, pathogens may also cause cellulitis after hematogenous or lymphatic spread from distant foci of infection. The most common etiologic agents of cellulitis are β-hemolytic Streptococcus spp. and Staphylococcus aureus .
- Pyoderma is a deep skin infection associated with pus formation. Similar to the aforedescribed conditions, Gram-positive cocci account for the majority of pyoderma cases. Of note, pyoderma gangrenosum is a skin disease of unknown etiology. It is marked by deep ulcers and necrotizing areas, but intents to isolate causative pathogens usually yield negative results.
- Folliculitis describes an inflammation of hair follicles; it is most commonly caused by an infection with Staphylococcus aureus, Pseudomonas aeruginosa or fungi. Accordingly, folliculitis can be detected in patients suffering from tinea capitis, tinea corporis and tinea pedis, among others.
- Purulent inflammation of hair follicles and development of small abscesses characterize furunculosis .
- Warts are the result of benign epithelial growth triggered by an infection with human papillomavirus, which is largely facilitated by pre-existing epithelial lesions.
All measures aiming at the preservation of the integrity of the skin and a strong immune system may help to reduce the individual risk of skin infections. With regards to the former, both a lack of skin hygiene as well as an excess to this effect may have detrimental consequences. The physiological skin flora protects from infections by means of competitive exclusion. Thus, alterations of the normal microbiome may predispose for skin infections.
Moreover, direct contact to contaminated skin or surfaces should be avoided. To this end, it is recommended to cover wounds, not to share personal hygiene products, to wash hands regularly, and to use disinfectants when necessary.
The skin is the human's largest organ and covers an area of approximately 1.8 square meters in adults . It fulfills a myriad of functions, one of them being to protect the human body from noxious agents present in its environment. Since the skin constitutes the interface with the outside world, it is continuously exposed to such noxious agents, e.g., to bacterial, fungal or viral microorganisms. Under determined conditions, which are discussed further in the following sections of this article, those microorganisms may invade the patient's skin and start to multiply in excess. This way, a skin infection develops.
The vast majority of skin infections are not life-threatening, but they may considerably restrict the patient's quality of life. Their diagnosis is usually based on physical examination alone, and treatment is often chosen empirically. And indeed, this rapid, low-cost approach to therapy may work since most types of skin infection are caused by only few distinct pathogens. However, it also bears the risk of misdiagnosis, inappropriate treatment and spread of infection. Thus, further diagnostic measures are indicated in case of severe skin infections, e.g., isolation and determination of the causative pathogen and histopathological analysis of skin biopsy samples.
Skin infection is a very general term; it refers to the invasion and multiplication of pathogens within the patient's skin. Skin infections may be provoked by bacteria, fungi and viruses, whereby the most common causative agents are Staphylococcus aureus, Streptococcus spp., and dermatophytes. Distinct skin infections vary largely regarding their manifestation, their severity and extension, as well as their distribution across the population.
Some types of skin infection are very common, e.g., impetigo, superficial, bacterial infection mainly diagnosed in pediatric patients, and tinea pedis, which is also known as "athlete's foot"; others are rare. Although few skin infections are life-threatening, pain, pruritus and psychological stress associated with such diseases may considerably reduce the patient's quality of life. The vast majority of those infections is curable, but affected individuals tend to delay medical checks until the infection spread. This behavior leads to prolonged treatment times, higher costs and possibly a worse prognosis. Thus, it is recommended to consult a physician in a timely manner, and to learn about possible preventive measures. The physician may clear any doubts regarding a proper skin hygiene.
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