Impetigo: Difference between revisions

Latest revision as of 16:35, 11 December 2024

Background

Normal dermal anatomy.

Superficial epidermal infection characterized by amber crusts (nonbullous) or vesicles (bullous)
May be super-infection or primary infection
- Typical causative organisms are Staphylococcus aureus or Streptococcus pyogenes
Fever and systemic signs are uncommon
Post-streptococcal glomerular nephritis is a possible complication, and incidence is not reduced by antibiotic therapy
Highly contagious and easily transmittable

Clinical Features

Impetigo honey-colored scab

Impetigo on the back of the neck.

Bullous impetigo after the bulla have broken.

Nonbullous
- Erythematous macules/papules develop into vesicles which become pustular and rupture
  - As rupture release yellow fluid which dries to form stratified golden crust
Bullous
- Bullae form as result of staph toxin
- Some cases caused by MRSA
Uncommonly painful, but usually pruritic
Regional lymphadenopathy is common

Differential Diagnosis

Other Rash

Evaluation

Clinical diagnosis

Management

Antibiotics

Coverage for MSSA, MRSA, Group A Strep

Topical therapy

Mupirocin (Bactroban) 2% ointment q8hrs x 5 days
- For nonbullous impetigo, topic antibiotics are as effective as oral antibiotics

Oral Therapy

Cephalexin 500mg (6.25mg/kg) PO q6hrs for 10 days OR
Amoxicillin/Clavulanate 875mg (12.5mg/kg) PO q12hrs daily x 10 days OR
Clindamycin 450mg PO q8hrs daily (or 10mg/kg PO q6hrs) for 10 days OR
Dicloxacillin 500mg (3mg/kg) PO q6hrs daily x 10 days

Disposition

Outpatient

References

Authors:

@@ Line 1: / Line 1: @@
-==Treatment==
+==Background==
+{{Skin anatomy background images}}
+*Superficial epidermal infection characterized by amber crusts (nonbullous) or vesicles (bullous)
+*May be super-infection or primary infection
+**Typical causative organisms are ''[[Staphylococcus aureus]] or [[Streptococcus pyogenes]]''
+*Fever and systemic signs are uncommon
+*[[Post-streptococcal glomerular nephritis]] is a possible complication, and incidence is not reduced by antibiotic therapy
+*Highly contagious and easily transmittable
+==Clinical Features==
+[[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]]
+[[File:Impetigo-infected.jpg|thumb|Impetigo on the back of the neck.]]
+[[File:Bullous impetigo1.jpg|thumb|Bullous impetigo after the bulla have broken.]]
+*[[rash|Nonbullous]]
+**Erythematous macules/papules develop into vesicles which become pustular and rupture
+***As rupture release yellow fluid which dries to form stratified golden crust
+*[[vesiculobullous rashes|Bullous]]
+**Bullae form as result of staph toxin
+**Some cases caused by [[MRSA]]
+*Uncommonly painful, but usually pruritic
+*Regional [[lymphadenopathy]] is common
-) --> bacitracin
+==Differential Diagnosis==
+{{Generalized rash DDX}}
-) --> Bactroban
+==Evaluation==
+*Clinical diagnosis
-) spread or immunomp --> keflex
+==Management==
+===[[Antibiotics]]===
---> cover MRSA if RF
+{{Impetigo Antibiotics}}
+==Disposition==
+*Outpatient
+==See Also==
+*[[Rash]]
+==References==
+<references/>
+[[Category:Dermatology]]
 [[Category:ID]]