Impetigo

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
• Postinfectious Glomerulonephritis is a possible complication

Diagnosis

• 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

Impetigo honey-colored scab

Treatment

• Topical abx
  • 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

Tintinalli