Impetigo

Definition

Impetigo is a superficial infection of the skin. It is an infectious disease transmitted only by direct contact from the affected person. This bacterial skin infection is also known as school sores which is most common among the pre-school children.

Information on Impetigo

Causative agent: Beta-hemolytic streptococcus, group A (nonbullous), Staphylococcus Aureus (bullous)

Incubation Period: 2-5 days

Period of communicability: from the outbreak of the lesions until the lesions are healed

Mode of transmission: direct contact with lesions. Scratching may spread the lesions.

Immunity: none

Classification

  1. Bullous Impetigo – this type of impetigo primarily affects infants and children younger than 2 years. Painless and fluid-filled blisters are found on the trunk, arms and legs in children with bullous impetigo. The surrounding akin of the blisters may be red and itchy but not sore. When the blisters break, they scab over with a yellow-colored crust that lasts longer than sores from other type of impetigo.
  2. 2. Ecthyma – this is the more serious form of impetigo. The infection in ecthyma penetrates deeper into the second layer of the skin which is the dermis.

Clinical Manifestations

This infectious disease begins as a single papulovesicular lesion that is surrounded by a localized redness or erythema. Later on, more vesicles will appear and they will become purulent. As the disease progresses, the vesicles ooze and form a honey-colored crusts. The lesions are found mostly on the extremities and the face. Local adenopathy may occur if an enormous number of lesions will be noted.

Management

  1. Penicillin or Erythromycin orally administered.
  2. Application of mupirocin (Bactroban) ointment for 7 to 10 days.
  3. Wash the crusts daily with soap and water for the lesions to heal quickly.
  4. Contact precautions should be implemented.
  5. Instruct the patient to stay indoors for a few days to stop any bacteria from getting into the blisters and making the infections worse.
  6. The infected person’s bed linens, towels, and clothing should be separated from those of other family members.
  7. The infected person should use separate towels for bathing and hand washing.

Prevention

  1. Good hygiene.
  2. Injured skin areas should be kept clean and covered with clean gauze to prevent infection.
  3. Regular and effective hand washing practice.
  4. Keep fingernails cut short.

Possible Complications

  1. Rheumatic fever
  2. Acute glumerolunephritis

image from faculty.ksu.edu.sa

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

What Do You Think?