Difference between revisions of "Impetigo"
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*[[Post-streptococcal glomerular nephritis]] is a possible complication | *[[Post-streptococcal glomerular nephritis]] is a possible complication | ||
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[[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]] | [[File:ImpetigoF.jpg|thumb|Impetigo honey-colored scab]] | ||
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| + | ==Clinical Features== | ||
*Nonbullous | *Nonbullous | ||
**Erythematous macules/papules develop into vesicles which become pustular and rupture | **Erythematous macules/papules develop into vesicles which become pustular and rupture | ||
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**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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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Generalized rash DDX}} | {{Generalized rash DDX}} | ||
| − | == | + | ==Diagnosis== |
| + | *Clinical diagnosis | ||
| + | |||
| + | ==Management== | ||
===[[Antibiotics]]=== | ===[[Antibiotics]]=== | ||
{{Impetigo Antibiotics}} | {{Impetigo Antibiotics}} | ||
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*[[Rash]] | *[[Rash]] | ||
| − | == | + | ==References== |
| − | + | <references/> | |
[[Category:Derm]] | [[Category:Derm]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 00:14, 22 February 2016
Contents
Background
- 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
Clinical Features
- Nonbullous
- Erythematous macules/papules develop into vesicles which become pustular and rupture
- As rupture release yellow fluid which dries to form stratified golden crust
- Erythematous macules/papules develop into vesicles which become pustular and rupture
- Bullous
- Bullae form as result of staph toxin
- Some cases caused by MRSA
Differential Diagnosis
Rash
- Acute generalized exanthematous pustulosis
- Allergic reaction
- Aphthous stomatitis
- Atopic dermatitis
- Chickenpox
- Chikungunya
- Coxsackie
- Dermatitis herpetiformis
- Erysipelas
- Exfoliative erythroderma
- Impetigo
- Measles
- Miliaria (Heat Rash)
- Necrotizing fasciitis
- Pellagra
- Poison Oak, Ivy, Sumac
- Psoriasis
- Pityriasis rosea
- Scabies
- Seborrheic dermatitis
- Serum Sickness
- Smallpox
- Shingles
- Tinea capitus
- Tinea corporis
- Vitiligo
Diagnosis
- 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