Difference between revisions of "Impetigo"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
(Clinical Features)
 
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**Typical causative organisms are ''[[Staphylococcus aureus]] or [[Streptococcus pyogenes]]''
 
**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
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*[[Post-streptococcal glomerular nephritis]] is a possible complication, and incidence is not reduced by antibiotic therapy
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*Highly contagious and easily transmittable
  
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==Clinical Features==
 
[[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]]
 
[[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]]
 
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[[File:Impetigo-infected.jpg|thumb|Impetigo on the back of the neck.]]
==Clinical Features==
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[[File:Bullous impetigo1.jpg|thumb|Bullous impetigo after the bulla have broken.]]
*Nonbullous  
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*[[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
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*[[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]]
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*Uncommonly painful, but usually pruritic
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*Regional [[lymphadenopathy]] is common
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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===[[Antibiotics]]===
 
===[[Antibiotics]]===
 
{{Impetigo Antibiotics}}
 
{{Impetigo Antibiotics}}
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==Disposition==
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*Outpatient
  
 
==See Also==
 
==See Also==

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