Impetigo

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Impetigo
Synonyms	School sores
Pronounce	N/A
Specialty	N/A
Symptoms	Red sores, blisters, itching
Complications	Cellulitis, post-streptococcal glomerulonephritis
Onset	More common in children
Duration	2–3 weeks
Types	N/A
Causes	Bacterial infection (Staphylococcus aureus, Streptococcus pyogenes)
Risks	Crowded living conditions, poor hygiene, warm and humid climate
Diagnosis	Physical examination, bacterial culture
Differential diagnosis	Contact dermatitis, herpes simplex, scabies
Prevention	Hand washing, cleaning wounds
Treatment	Antibiotics (topical or oral)
Medication	Mupirocin, cephalexin
Prognosis	N/A
Frequency	Common
Deaths	Rare

Impetigo is a highly contagious bacterial skin infection that primarily affects children, but it can also occur in adults. The condition is characterized by the appearance of red sores and blisters that can rupture, leaving a yellowish crust. Impetigo is usually caused by two types of bacteria: Staphylococcus aureus and Streptococcus pyogenes. The infection can spread through close contact or by touching contaminated objects, such as towels or toys. Treatment typically involves the use of topical or oral antibiotics, and good hygiene practices can help prevent the spread of the infection.

Causes

Impetigo is most commonly caused by the following bacteria:

• Staphylococcus aureus (S. aureus): This type of bacteria is often found on the skin and in the nose of healthy individuals but can cause infections when it enters through a break in the skin, such as a cut, scrape, or insect bite.
• Streptococcus pyogenes (S. pyogenes): Also known as Group A streptococcus, this bacterium can cause various infections, including impetigo, strep throat, and cellulitis.

Types of Impetigo

There are two main types of impetigo:

• Non-bullous impetigo: This is the most common form of impetigo, characterized by the appearance of small red sores that rupture and form a honey-colored crust. It is typically caused by both S. aureus and S. pyogenes.
• Bullous impetigo: This form of impetigo is characterized by larger fluid-filled blisters (bullae) that can rupture and leave a yellow crust. Bullous impetigo is typically caused by S. aureus, which produces a toxin that leads to the formation of blisters.

Symptoms

The symptoms of impetigo can vary depending on the type of infection: Non-bullous impetigo: Small red sores, often on the face (particularly around the nose and mouth) or limbs Rupture of the sores, leaving a yellowish crust Itching and discomfort at the site of the sores Bullous impetigo:

• Larger fluid-filled blisters, often on the trunk or limbs
• Rupture of the blisters, leaving a yellow crust
• Itching and discomfort at the site of the blisters
• In some cases, fever and swollen lymph nodes

Diagnosis

Impetigo is typically diagnosed through a physical examination by a healthcare professional. In some cases, a swab of the affected area may be taken and sent to a laboratory for bacterial culture and identification to confirm the diagnosis and determine the appropriate antibiotic treatment.

Treatment

The treatment for impetigo usually involves the use of antibiotics:

• Topical antibiotics: For mild cases of impetigo, a topical antibiotic ointment, such as mupirocin, can be applied to the affected areas. This treatment is typically continued for 5 to 7 days, or until the infection has cleared.
• Oral antibiotics: For more severe cases of impetigo or when topical treatment is insufficient, oral antibiotics, such as penicillin or erythromycin, may be prescribed. It is important to complete the entire course of antibiotics to ensure that the infection is fully treated and to prevent recurrence or antibiotic resistance.

In addition to antibiotic treatment, good hygiene practices can help prevent the spread of the infection and promote healing:

• Keep the affected areas clean and dry, and gently wash the sores with mild soap and water.
• Avoid touching, scratching, or picking at the sores to prevent the spread of bacteria and the development of scars.
• Cover the affected areas with a loose, non-stick bandage or dressing.
• Change the dressings and clean the affected areas as directed by your healthcare professional.
• Wash hands frequently, especially after touching the infected areas, to prevent the spread of bacteria to other parts of the body or to other people.
• Avoid sharing personal items, such as towels, clothing, or toys, with others to prevent the spread of infection.
• Keep the nails short and clean to minimize the risk of spreading the bacteria through scratching.

Complications

Although impetigo is generally a mild and self-limiting condition, it can sometimes lead to complications, such as:

• Cellulitis: A deeper skin infection that can spread to the underlying tissues, causing redness, swelling, and warmth. Cellulitis requires prompt medical attention and treatment with oral or intravenous antibiotics.
• Post-streptococcal glomerulonephritis: A rare complication that can occur after a streptococcal infection, including impetigo caused by S. pyogenes. This condition affects the kidneys and can cause symptoms such as dark-colored urine, swelling, and high blood pressure. Treatment may include medications to manage blood pressure and inflammation, as well as antibiotics to treat any remaining infection.
• Scar formation: In some cases, impetigo can lead to scarring, especially if the affected areas are scratched or picked at during the healing process.

Prevention

To prevent impetigo and minimize the risk of spreading the infection, it is important to practice good hygiene: Wash hands frequently, especially after using the bathroom, before preparing or eating food, and after touching or caring for someone with impetigo. Keep cuts, scrapes, and insect bites clean and covered to prevent bacterial infections. Avoid close contact with individuals who have impetigo or other skin infections. Do not share personal items, such as towels, clothing, or toys, with others.

References

• [1] Impetigo - Symptoms and causes. (2020, December 17). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/impetigo/symptoms-causes/syc-20352352
• [2] Impetigo. (2018, July 9). NHS. Retrieved from https://www.nhs.uk/conditions/impetigo/
• [3] Impetigo. (2020, November 23). MedlinePlus. Retrieved from https://medlineplus.gov/impetigo.html

Summary

Impetigo is a highly contagious skin infection caused by bacteria, usually occurring around the nose and mouth; commonly occurring in children.

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