Difference between revisions of "Impetigo"

(Treatment)
(Clinical Features)
 
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*Superficial epidermal infection characterized by amber crusts (nonbullous) or vesicles (bullous)
 
*Superficial epidermal infection characterized by amber crusts (nonbullous) or vesicles (bullous)
 
*May be super-infection or primary infection
 
*May be super-infection or primary infection
 +
**Typical causative organisms are ''[[Staphylococcus aureus]] or [[Streptococcus pyogenes]]''
 
*Fever and systemic signs are uncommon
 
*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
  
==Diagnosis==
+
==Clinical Features==
*Nonbullous  
+
[[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
 
**Erythematous macules/papules develop into vesicles which become pustular and rupture
 
***As rupture release yellow fluid which dries to form stratified golden crust
 
***As rupture release yellow fluid which dries to form stratified golden crust
*Bullous
+
*[[vesiculobullous rashes|Bullous]]
 
**Bullae form as result of staph toxin
 
**Bullae form as result of staph toxin
**Some cases caused by MRSA
+
**Some cases caused by [[MRSA]]
[[File:ImpetigoF.jpg|center|frame|500px|Impetigo honey-colored scab]]
+
*Uncommonly painful, but usually pruritic
 +
*Regional [[lymphadenopathy]] is common
  
==Treatment==
+
==Differential Diagnosis==
*Topical abx
+
{{Generalized rash DDX}}
**Mupirocin ointment 2% TID x 7-14d
 
*Oral abx
 
**Consider for large areas or if topical tx is impractical or for [[bullous impetigo]]
 
**[[Clindamycin]] 24mg/kg/d in 3 doses x7-10d
 
  
==Source==
+
==Evaluation==
Tintinalli
+
*Clinical diagnosis
  
[[Category:Derm]]
+
==Management==
 +
===[[Antibiotics]]===
 +
{{Impetigo Antibiotics}}
 +
 
 +
==Disposition==
 +
*Outpatient
 +
 
 +
==See Also==
 +
*[[Rash]]
 +
 
 +
==References==
 +
<references/>
 +
 
 +
[[Category:Dermatology]]
 
[[Category:ID]]
 
[[Category:ID]]

Latest revision as of 22:49, 27 September 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