Impetigo Flashcards
What is impetigo?
A superficial bacterial skin infection
What bacteria usually causes impetigo?
Staphylococcus aureus Streptococcus pyogenes (beta haemolytic)
Who does it typically affect?
Children, particularly during warm weather
Peak incidence = 2 to 5 years
It can be a primary infection or…
Complication of existing skin condition e.g eczema, scabies or insect bites
Where do lesions typically occur?
On face, flexures and limbs not covered in clothing
But can occur anywhere
How is it spread?
By direct contact with discharges from scabs of an infected person. Bacteria invades skin through minor abrasions and then spread to other sites by scratching.
Can be spread by hands, by indirect spread via toys, clothing, equipment
What is the incubation period?
4 to 10 days
What are the clinical features?
Golden, crusted skin lesions on erythematous base
Vesicles and blisters
Well defined
Typically around mouth and nose
How is limited local disease managed?
Hydrogen peroxide 1% cream 2-3 times a day for 5 days
If unsuitable - short course of topical antibiotics:
Fusidic acid 2% TDS for 5 days or Mupirocin 2%
If widespread but not systemically unwell - short course of topical or oral antibiotics
How is it managed if systemically unwell, bullous impetigo or high risk of complications?
Oral flucloxacillin QDS for 7 days
Oral erythromycin if penicillin allergic
Should children go to school?
No not until lesions are crusted and healed or 48 hours after starting antibiotics
It is very contagious
Does it usually heal without scarring?
Yes
What hygiene advice should be given?
Wash affected areas with soap and water Wash hands regularly Avoid scratching Avoid sharing towels Clean potentially contaminated toys
What is bullous impetigo?
Lesions appear as flaccid fluid filled blisters and bullae
Also vesicles present
Blisters can rupture
Can persist for 2-3 days
Systemic features may occur if large areas of skin affected - fever, lymphadenopathy, diarrhoea, weakness
What risk factors are there for impetigo?
Child
Poor hygiene/ over crowding
Already have a skin disease e.g eczema
