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What is an Impetigo?

  • Impetigo is a common infection of the skin. It is contagious, which means it can be passed on by touching. It is usually caused by bacteria.
  • Impetigo is a superficial disease. This means that it is on the surface of skin.
  • Most common in children and can affect skin with no visible breaks in it.

 

What causes impetigo?

  • You are exposed to the bacteria that cause impetigo when you come into contact with the sores of someone who’s infected or with items they’ve touched such as clothing, bed linen, towels and even toys.
  • The breaking of the barrier of skin. Some of these occurrences are animal bites, human bites, injury or trauma, or insect bites.

 

Symptoms of impetigo

Impetigo symptoms can be uncomfortable and embarrassing, particularly when they are present on the face. Though the symptoms vary slightly from type to type of impetigo, they are similar and can include:

  • Red sores that pop easily and leave a yellow crust.
  • Fluid-filled blisters.
  • Itchy rash.
  • Skin lesions.
  • Swollen lymph nodes.

 

What are types of impetigo?

  1. non-bullous impetigo, which typically affects the skin around the nose and mouth, causing sores to develop that quickly burst to leave a yellow-brown crust.
  2. bullous impetigo, which typically affects the trunk (the central part of the body between the waist and neck), causing fluid-filled blisters (bullae) to develop that burst after a few days to leave a yellow crust.
  • Both types of impetigo may leave behind some red marks when the crusts have cleared up, but these will usually improve over the following days or weeks.

Who gets impetigo?

  • Impetigo can affect people of any age, but it tends to affect infants and children more often than adults.
  • Non-bullous impetigo is the most common type of impetigo. Bullous impetigo is most common in babies, although it can affect older children and adults too.

 

 

 

 

 

 

What could lifestyle factors increase a chance of Impetigo?

  • being two to six years of age
  • regularly attending a daycare or school
  • having skin irritated by other conditions
  • poor hygiene
  • warm weather
  • being in a crowded environment where bacteria can spread easily
  • having dermatitis (itchy, inflammation of the skin, sometimes caused by allergic reactions)
  • participating in activities that involve skin-to-skin contact
  • having diabetes
  • having a compromised immune system

 

How does Impetigo start?

  • The rash typically appears 4-10 days after infecting with bacteria.
  • Small blisters develop at first.
  • You may not see the blisters, as they usually burst to leave scabby patches on the skin. Sometimes only one or two patches develop.
  • They often look like moist, golden crusts stuck on to the skin.
  • An area of redness (inflammation) may develop under each patch. Sometimes affected skin is just red and inflamed – especially if the ‘crust’ is picked or scratched off.

Diagnosis of Impetigo

·         Your doctor will examine your sores and ask about any recent injuries to the skin. Most cases of impetigo can be diagnosed through physical examination.

·         However, your doctor may wish to take a culture to determine the type of bacteria that is causing your impetigo.

·         Taking a culture involves brushing a swab over an affected area. This swab will then be sent to a lab to be tested for bacteria.

·         The information from this test can help your doctor decide whether you need antibiotics, as well as what type of antibiotics to prescribe.

How should it be treated?

According to Clinical Knowledge Summaries (CKS):

  • For localized infection, treat with topical fusidic acid (three to four times daily, for 7 days).

– Before the initial application of topical antibiotics, advise the person (or parent) to remove crusted areas by soaking them in soapy water, as long as this does not cause discomfort.

– Topical mupirocin, retapamulin, and antiseptics are not recommended initially.

  • For extensive infection, areas on which it would be impractical to use topical drugs, or severe infection (including systemic symptoms), treat with an oral antibiotic.
    • Oral flucloxacillin (four times daily for 7 days) is recommended first-line.
    • Oral clarithromycin (twice daily for 7 days) or erythromycin (four times daily for 7 days) are alternatives if the person is allergic to penicillins.

What if the treatment is not effective?

  • Swab to exclude other infections or resistant organisms.
  • Do not use repeated courses of a topical antibiotic.

What to do if impetigo gets worse

You need to go back to the doctor if any of these things happen:

  • sores last more than a week
  • sores become red or swollen
  • sores have pus in them
  • your child has a fever

The infection may have spread to other parts of the body or blood. Your child may need tests and antibiotics.

What is complications of impetigo?

complications can sometimes occur. Examples include:

  • Scarring: a deeper and more serious form of impetigo, can leave scars.
  • Cellulitis: is an infection of the deeper layers of the skin and the underlying tissue.
  • Kidney problems (rare):One of the types of bacteria that causes impetigo can also damage your kidneys.

What is prognosis of impetigo?

  • Impetigo should heal without scarring, as long as the child doesn’t pick the bumps and blisters. Infants are more likely to develop complications of impetigo, such as inflammation of the kidneys and infection of the blood.
  • Impetigo cures easily, there are no impetigo complications after treatment in nine out of ten cases.

Prevention of Impetigo

Good hygiene can help you prevent impetigo. These methods include:

  • washing hands regularly.
  • bathing or showering regularly.
  • cleaning and covering any injuries to the skin.

If you have impetigo, there are several things you should due to prevent it from spreading to other areas of the body, as well as to other individuals. These include:

  • using antibacterial soap to wash hands
  • using a clean towel or fresh paper towel to dry the body or hands
  • washing linens and clothes in hot water
  • cleaning surface areas in the home with antibacterial products
  • keeping fingernails short
  • avoiding schools and childcare centres while infection is contagious
  • not sharing personal hygiene itemsp(4)

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