impetigo

what group of children are more at risk for impetigo?

children receiving dialysis

treatment for severe impetigo with MRSA

clindamycin, Bactrim, or vancomycin

Ecthyma

ulcerative form of impetigo lesions extend to the dermis punched out ulcers, raised margins covered in yellow crust * most common in lower extremities with regional lymphadenopathy present homeless, garbage workers, alcoholics, neg. elderly may start as an insect bite. Pruritic, erythematous.

s/s of impetigo

vesicles whose roofs breakdown leaving shallow erosions with yellowish crusts lesions may be discrete or confluent often on the face regional lymph node involvement

how is impetigo diagnosed?

A specific microbiologic diagnosis is rarely made or necessary. Look for "weeping, oozing, honey-colored lesions."

complications of impetigo

Acute poststreptococcal glomerulonephritis is a serious complication that affects between 1 and 5 percent of patients with nonbullous impetigo. Rare cx are osteomyelitis, septic arthritis, pneumonia.

Impetigo

Impetigo is a highly contagious, superficial vesiculopustular skin infection that most commonly affects children two to five years of age. Among children, impetigo is the most common bacterial skin infection and the third most common skin disease overall, behind dermatitis and viral warts.

causes of impetigo

Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus (MRSA) is becoming a common cause. GABHS, GBBHS

Treatment for mild non-bullous impetigo

Mupirocin 2% (topical antibiotic) usually heals without tx in 2-3 weeks usually heals with tx in 7-10 days OTC ointments may not be effective

what is the difference between bullous and non-bullous impetigo?

Nonbullous impetigo represents a host response to the infection, whereas a staphylococcal toxin causes bullous impetigo and no host response is required to manifest clinical illness.

Impetigo - Non-bullous type

begins as a single red macule or papule that quickly becomes a vesicle. The vesicle ruptures easily to form an erosion, and the contents dry to form characteristic honey-colored crusts that may be pruritic. This infection tends to affect areas subject to environmental trauma, such as the extremities or the face. Spontaneous resolution without scarring typically occurs in several weeks if the infection is left untreated. 70% OF CASES

impetigo bullous

most commonly affects neonates caused by toxin-producing S. aureus a localized form of staphylococcal scalded skin syndrome Superficial vesicles progress to rapidly enlarging, flaccid bullae with sharp margins and no surrounding erythema. When the bullae rupture, yellow crusts with oozing result. 30% of cases

treatment for mild to moderate impetigo with MRSA

retapamulin topical

treatment for severe impetigo

systemic ATB, cephalosporin in children, first line is cephalexin