Bacterial infections

Question 1

Explain impetigo

Answer 1

School sores
Any age if infected
Bacterial infection from staph aureus or strep pyogenes
Socioeconomically challenged= strep
highly contagious

risk factors hot/humid, poor hygiene, skin trauma, diabetes, immunocompromised.

Question 2

Signs and symptoms of impetigo

Answer 2

Begins in minor cuts, insect bites.
Itchy and painful.

Non-bullous= most common, yellow crusted lesion. Face and extremities. Staph and strep.

Bullous- Staph. Large fluid filled vesicles.
Newborns.
Vesicle ruptures to form crust.
Single/multiple lesion w/in 34-48hrs. Nose and mouth.

Question 3

Classification of primary vs secondary impetigo infection

Answer 3

Primary - invasion of normal skin
Secondary - infection at sites of damaged skin

Question 4

Pathogenesis of folliculitis

Answer 4

Inflammatory reaction of hair follicle
Infection, blockage, or irritation
Hot weather
Occlusion of hair follicle opening = infection
Shaving, sweating, maceration.

Question 5

Signs and symptoms of folliculitis

Answer 5

Small red micropapule around hair follicle
Develop into pustule over 48 hrs
Mild pain/discomfort
Single, few, or many pustules

Question 6

Classification of folliculitis

Answer 6

Bacterial - S. aureus.

Superficial- bacterial and/or yeast. tender red spot at hair follicle, small surface pustule.

Deep- entire hair follicle, severe symptom, painful boil

Question 7

Impetigo treatment in remote settings

Answer 7

S. pyogenes - common

Benzathine penicillin IM single dose
or

Trimethoprim + sulfamethoxazole oral od or bd for 5 days

Question 8

Impetigo treatment

Answer 8

Remove crust w/ saline, soap, water. tds or qid.
contagious.
exclude until abx treatment
cover exposed sores.

Hygiene - don’t scratch

Medical intervention if spreading in public

Depends on age, extent, and severity.

Question 9

Impetigo treatment in non-remote setting

Answer 9

S. aureus - pathogen

Topical abx for localised sores
- mupirocin 2% ointment/cream q8h for 5 days

oral abx for multiple/recurrent
- di/fluclox oral q6h 7 days
- cephalexin oral q6h 7 days
trimethoprim + sulfamethoxazole q12hr 3 days

Question 10

Treatment of infective folliculitis

Answer 10

Swab to determine organism
Use general measures and appropriate abx

Question 11

Treatment of non-infective folliculitis

Answer 11

General measures (warm compresses, antiseptic wash, clean sharp razors, avoid using oils, avoid triggers.

Question 12

Referral of bacterial infections

Answer 12

Impetigo needing S4
Severe folliculitis

Question 13

Lifestyle changes

Answer 13

Wash and disinfect toys, clothes, linen, towels, etc.
cover wounds or cuts
Don’t scratch sores