Difference between revisions of "Impetigo"

(Clinical Features)
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[[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]]
 
[[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]]
 
[[File:Impetigo-infected.jpg|thumb|Impetigo on the back of the neck.]]
 
[[File:Impetigo-infected.jpg|thumb|Impetigo on the back of the neck.]]
 +
[[File:Bullous impetigo1.jpg|thumb|Bullous impetigo after the bulla have broken.]]
 
*Nonbullous  
 
*Nonbullous  
 
**Erythematous macules/papules develop into vesicles which become pustular and rupture
 
**Erythematous macules/papules develop into vesicles which become pustular and rupture

Revision as of 18:39, 17 August 2019

Background

  • Superficial epidermal infection characterized by amber crusts (nonbullous) or vesicles (bullous)
  • May be super-infection or primary infection
  • 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

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

Disposition

  • Outpatient

See Also

References