Impetigo

Introduction

  • Impetigo is a highly contagious bacterial skin infection, most common in young children but can affect individuals of any age.
  • It is caused by Staphylococcus aureus or Streptococcus pyogenes.
  • The condition typically presents as red sores that rupture, ooze, and form a honey-colored crust.
  • Effective treatment includes good hygiene, topical or oral antibiotics, and preventive measures to reduce spread.

Types of Impetigo

  1. Non-Bullous Impetigo
    • Most common form.
    • Small red sores that develop into crusted patches.
  2. Bullous Impetigo
    • Characterized by large, fluid-filled blisters.
    • More common in infants and young children.
  3. Ecthyma
    • A more severe form that penetrates deeper into the skin.
    • Can cause ulceration and scarring.

Causes of Impetigo

  1. Bacterial Infection
    • Staphylococcus aureus: Most common cause.
    • Streptococcus pyogenes: Less common but may lead to complications.
  2. Skin Trauma
    • Minor cuts, insect bites, or scratches that allow bacteria to enter.
  3. Risk Factors
    • Crowded living conditions.
    • Poor hygiene.
    • Warm, humid climates.
    • Skin conditions like eczema or dermatitis.

Symptoms of Impetigo

  1. Non-Bullous Impetigo
    • Red sores around the nose, mouth, hands, or other exposed areas.
    • Honey-colored crusts after sores burst.
  2. Bullous Impetigo
    • Fluid-filled blisters that enlarge before bursting.
    • Leave behind a yellowish crust or raw red skin.
  3. General Symptoms
    • Itching and discomfort.
    • Rarely, fever or swollen lymph nodes in severe cases.

Complications of Impetigo

  • Cellulitis: Deeper skin infection that may require urgent treatment.
  • Scarlet Fever: Caused by Streptococcus bacteria.
  • Post-Streptococcal Glomerulonephritis: Rare kidney complication following Streptococcal impetigo.
  • Spread to Others: Highly contagious, particularly among children in close contact.

Diagnosis of Impetigo

  1. Clinical Examination
    • Visual inspection of characteristic lesions.
  2. Laboratory Tests (if needed)
    • Swab and Culture: Confirms bacterial cause and checks antibiotic sensitivity.
    • PCR Testing: Identifies specific bacterial strains.

Treatment Options for Impetigo

1. Topical Antibiotics

MedicationBrand NameManufacturerCost Range
MupirocinBactrobanGSK$10–$30 per tube
RetapamulinAltabaxGSK$20–$50 per tube
Fusidic AcidFucidinLeo Pharma$10–$20 per tube
  • Applied directly to the affected area for mild to moderate cases.

2. Oral Antibiotics

MedicationBrand NameManufacturerCost Range
CephalexinKeflexEli Lilly$15–$40 per course
Amoxicillin-ClavulanateAugmentinGSK$20–$50 per course
ClindamycinCleocinPfizer$25–$60 per course
  • Used for widespread or severe infections.

3. Supportive Care

  • Hygiene Measures
    • Wash affected areas gently with soap and water.
    • Avoid touching or scratching lesions to prevent spread.
  • Pain Relief
    • Paracetamol or ibuprofen for associated discomfort.

Prevention of Impetigo

  1. Personal Hygiene
    • Frequent handwashing with soap.
    • Keeping nails short and clean.
  2. Avoid Sharing Personal Items
    • Towels, clothing, or bedding.
  3. Treat Minor Skin Injuries
    • Clean and cover cuts or insect bites promptly.
  4. Isolate the Infected Individual
    • Avoid close contact until lesions heal.

Monitoring Parameters

  • Resolution of lesions within 7–10 days of treatment.
  • Absence of fever or spreading infection.
  • Monitor for complications like cellulitis or kidney issues.

Patient Counseling Points

  • Explain the importance of completing the full course of antibiotics.
  • Encourage frequent handwashing to prevent spread.
  • Advise avoiding scratching or picking at sores to reduce scarring risk.
  • Discuss proper hygiene practices for household contacts to prevent transmission.

Use in Children

  • Commonly affects children; prioritize topical treatments for mild cases.

Use in Pregnancy

  • Topical antibiotics are preferred. Consult a doctor before using oral antibiotics.

Use in Elderly

  • Monitor for underlying conditions that may delay healing, such as diabetes.

FAQs About Impetigo

Q1: What causes impetigo?

  • Bacterial infection by Staphylococcus aureus or Streptococcus pyogenes.

Q2: Is impetigo contagious?

  • Yes, highly contagious through direct contact or contaminated items.

Q3: How is impetigo treated?

  • With topical or oral antibiotics and good hygiene.

Q4: Can adults get impetigo?

  • Yes, though it is more common in children.

Q5: How long does impetigo last?

  • Symptoms resolve in 7–10 days with treatment.

Q6: Can impetigo cause scars?

  • Non-bullous impetigo rarely scars; severe cases of ecthyma may leave scars.

Q7: How can I prevent impetigo from spreading?

  • Practice good hygiene, avoid scratching, and keep lesions covered.

Q8: Can I treat impetigo at home?

  • Mild cases may be managed with hygiene and topical antibiotics, but severe cases require medical attention.

Q9: What are the symptoms of impetigo?

  • Red sores, blisters, and honey-colored crusts.

Q10: Can impetigo recur?

  • Yes, particularly if hygiene practices are poor or in crowded conditions.

Q11: Is impetigo serious?

  • Usually mild, but complications like cellulitis can occur if untreated.

Q12: Should I keep my child home from school?

  • Yes, until 24–48 hours after starting antibiotic treatment.

Q13: Are there home remedies for impetigo?

  • Proper hygiene is crucial, but medical treatment is necessary for complete resolution.

Q14: Can pets transmit impetigo?

  • Rarely, but pets can carry bacteria that may contribute to infections.

Q15: When should I see a doctor?

  • If symptoms worsen, spread, or do not improve within a few days of treatment.