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Bacterial, Mycobacterial, and Spirochetal (Nonvenereal) Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Clinical presentation: Impetigo presents acutely with red sores or blisters, which can burst and leave behind crusty yellowish patches. They usually affect exposed areas, such as the hands and face, and can rapidly enlarge and spread to other body parts. Impetiginization refers to a superficial secondary skin infection of an underlying skin condition, such as dermatitis.
Bacteria
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Impetigo is a type of pyoderma caused by infection of the skin with Streptococcus pyogenes and then superinfection with Staphylococcus aureus. The infection is probably initiated at sites of injury although they may be microscopic. In impetigo, hy-aluronidase produced by S. pyogenes facilitates microbial spread in the connective tissue underlying the skin. Once infection is started, an humoral immune response occurs. This response does not appear to significantly aid clearance of the infection. The delayed type hypersensitivity response to the bacterial antigens causes itching of the skin which causes scratching which in turn spreads the infection.
The Child with Fever or a Rash
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Neal Russell, Bhanu Williams, Anna Battersby
Impetigo is a contagious bacterial skin infection that is common in childhood and usually uncomplicated. It is usually caused by staphylococci or less commonly streptococci and is commonly a secondary infection of skin damaged through eczema or trauma. Impetigo presents with golden crusted lesions, which may be painful/pruritic. Complications are rare but may include staphylococcal scalded skin syndrome, scarlet fever or glomerulonephritis (particularly with Group A haemolytic Streptococcus infection).2
A comparative review of current topical antibiotics for impetigo
Published in Expert Opinion on Drug Safety, 2021
Eugenio Galindo, Adelaide A Hebert
Impetigo is one of the most common pediatric dermatoses caused by bacterial infection of the epidermis. This infection predominantly affects pre-school and school-aged children ages 2 to 6 years of age, although adults can be affected as well. Globally estimates suggest that this disease affects 162 million children at a single moment [1,2]. Impetigo can be present in bullous or nonbullous forms. Nonbullous impetigo is more common (approximately 70% of cases) [3] and can be due to pathogens S. aureus and S. pyogenes. The classic primary lesion is manifested with pustules that form a yellow-golden crust, often localized around the nose and mouth or the extremities. Bullous impetigo is caused exclusively by S. aureus and presents with large superficial bullae with yellow fluid caused by bacterial toxins [3]. While the infection is considered ‘self-limiting,’ treatment is recommended to prevent spread of this contagious disease. School aged children often require isolation from school, work or activities and thus, early detection and prompt treatment remain paramount. Treatment of impetigo can range from use of topical disinfectants to topical or oral antibiotics. The treatment of choice for usually depends on the severity of the infection and experience of the prescribing clinician. In the past decade, increasing resistance rates to all antibiotics, including topical agents, remain a concern [2,4,5]. Currently the list of FDA-approved topical antibiotics includes Mupirocin, Retapamulin, and most recently Ozenoxacin. Outside of the United States, Fusidic Acid is approved in countries such as Europe, Australia, and parts of Asia.
Formaldehyde as an alternative to antibiotics for treatment of refractory impetigo and other infectious skin diseases
Published in Expert Review of Anti-infective Therapy, 2019
Philip Nikolic, Poonam Mudgil, John Whitehall
Impetigo is a skin infection that is most commonly found in children and can be caused by either S. aureus or Streptococcus pyogenes. Impetigo contributes to a high burden of disease in resource-poor communities with an estimated global burden of 162 million children in low to low-middle income countries being affected by impetigo at any one time. In Australia alone, it is estimated that over 15,000 indigenous children suffer from impetigo at any one time [41]. The human skin barrier is usually capable of preventing bacteria from causing impetigo. However, if this protective layer is compromised, by conditions such as chickenpox and scabies or through damage caused by scratching or surgery, bacteria can invade and colonize, leading to the development of impetigo.
Pediatric impetigo: an expert panel opinion about its main controversies
Published in Journal of Chemotherapy, 2022
Luisa Galli, Andrea Novelli, Giuseppe Ruggiero, Stefania Stefani, Anna Belloni Fortina
Oral antibiotics are indicated in addition to a topical treatment in cases with widespread or recurrent impetigo, independently from the bullous or non-bullous form. On the contrary, the proper management of complicated impetigo requires a systemic antibiotic treatment (topical treatment is not necessary in these subjects). Treatment of suppurative complications, such as abscesses, requires incision and drainage of the lesions, before starting topical antibiotics. Dermatologists suggest to disrupt the bottom of the blister/s, which favour topic antibiotic penetration. The panel recommend to monitor patients’ and caregivers’ compliance when a combined topic and oral antibiotic treatment is prescribed [7]. Readmission to the community life may occur only after a complete disappearance of cutaneous lesions, in order to reduce the risk of transmission. Impetigo is a contagious infection and schools are advised to exclude affected children until they have received at least 24/48 h of an appropriate antimicrobial therapy and after clinical improvement, thus respecting adequate hygienic conditions (because poor hygiene may increase the risk of transmission) as well as recommendation about not occlusive medication of cutaneous lesions. Good hygiene measures help prevent spread of impetigo to other areas of the body and to other people. According to the clinical practice, if lesions are placed on specific sites (such as the face or other exposes areas), patients should be kept at home and excluded from school and daycare centers (including gym and swimming pool) until their significant clinical improvement [8,9]. Because of its communicable nature, the social effects of impetigo can be serious, including loss of school and work days.