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Flashcards in Impetigo Deck (10):

What is impetigo?

- = Highly contagious bacterial infection of the epidermis


Common organisms causing impetigo

Bacteria that usually live on skin/in throat or nose:
• GABHS (group A beta-haemolytic streptococci)
• Strep pyogenes
• Staph aureus


Epidemiology: when most common?

- More common in hotter months and younger children 2-5y


Differentiate between the types of impetigo.

○ Non bullous 70%
• all ages
• Staph aureus & Group A strep
○ Bullous 30%
• Infants & pre-school children
• Vast majority Staph aureus


Why does impetigo usually occur?

- Can happen on healthy skin, but most commonly on already damaged skin e.g. cut, eczema


How is impetigo spread? How long is impetigo infectious for?

- Sore is infectious for as long as its weeping, and usually stops ~24h after abx
• Fluid and crusts contain bacteria
• Things that have touched sores e.g. dressings
• Self-spread from itching or seemingly non-affected areas e.g. runny nose


What are the key clinical features of impetigo?

- Starts with blisters
• commonly near mouth, nose, arms, legs
• Can be small spots around first spot, spreading outwards
• May be bullous blisters
- Blister bursts, leaving sores
- Sores develop honey-coloured crust +++, itch +++
+/- fever


What Ix should be done for impetigo?

• Skin swab for Gram stain (slide) and culture, test abx susceptibility


How to reduce spread of impetigo?

- Daily shower
○ Thoroughly wash grazes and cuts
○ Remove crusts, even if child taking abx: best way is to bathe for 20-30mins, and wipe crust with wet towel
- Cut nails short - prevent itching
- Cover sores with watertight dressings e.g. Tegaderm
- Throw everything used for the sores away immediately
- Wash affected things separately, and dry in sunshine or in hot dryer. Wash toys in disinfectant.
- Good hygiene - regular hand washing for pt and those in contact
- Don't return to child care/kinder/school until after 24h treatment started and sores completely covered


Tx for impetigo

- Topical mupirocin 2% ointment 8H for uncomplicated, localised sores
- If extensive / multiple lesions present / not responding to topical treatment: treat as for cellulitis (fluclox/cephalexin)