Impetigo

Question 1

What is impetigo?

Answer 1

• infectious (outbreaks in schools or families)
• caused by Staphylococcus aureus or sometimes Streptococcus pyogenes
• pustules and yellow/golden crust
• often needs a small scratch to start (can cause secondary infection in eczema or HSV)

Question 2

Presentation of bullous impetigo and non-bollous impetigo?

Answer 2

Bullous impetigo:

• pustules and blister
• always Staphylococcus
• blisters are due to staph toxins
• blisters aren’t painful but irritating
• brown crust when blisters burst

Non-bullous impetigo:

• Staph or strep
• not painful but itchy and irritating
• the one you think of when you hear impetigo

Question 3

Management of impetigo?

Complications?

Answer 3

• topical antibiotics eg mupirocin cream TDS 7days
• severe and widespread: PO flucloxacillin 500mg QID (adult) or 12.5mg/kg in kids, max 250mg

Other factors:

• cover lesions to reduce transmission
• cant cover then child off school until lesions have dried
• use antiseptics to clean wound
• dont share towels or clothes
• handwashing
• dont pick or scratch, can transfer it
• staph is in the nose so nose picking could be cause
• consider immune function in those with recurrent

COMPLICATIONS:

• post streptococcal glomerulonephritis
• rheumatic fever or rheumatic heart disease