Impetigo
Encyclopedia
Impetigo ɪmpɨˈtaɪɡoʊ is a highly contagious bacteria
l skin
infection
most common among pre-school children. People who play close contact sports such as rugby
, American football
and wrestling
are also susceptible, regardless of age. Impetigo is not as common in adults. The name derives from the Latin
impetere ("assail"). It is also known as school sores.
s — usually on the trunk, arms and legs. The skin
around the blister is usually red and itchy but not sore. The blisters, which break and scab
over with a yellow-colored crust, may be large or small, and may last longer than sores from other types of impetigo.
. Signs and symptoms include:
, and sometimes by Streptococcus pyogenes
. According to the American Academy of Family Physicians
, both bullous and nonbullous are primarily caused by Staphylococcus aureus, with Streptococcus also commonly being involved in the nonbullous form."
is spread by direct contact with lesion
s or with nasal
carriers. The incubation period
is 1–3 days. Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.
, and is often found on the arms, legs, or face.
practices can help prevent impetigo from spreading. Those who are infected should use soap
and water to clean their skin and take baths or showers regularly. Non-infected members of the household should pay special attention to areas of the skin that have been injured, such as cuts, scrapes, insect bites, areas of eczema
, and rash
es. These areas should be kept clean and covered to prevent infection. In addition, anyone with impetigo should cover the impetigo sores with gauze and tape. All members of the household should wash their hands thoroughly with soap regularly. It is also a good idea for everyone to keep their fingernails cut short to make hand washing more effective. Contact with the infected person and his or her belongings should be avoided, and the infected person should use separate towels for bathing and hand washing. If necessary, paper towels can be used in place of cloth towels for hand drying. The infected person's bed linens, towels, and clothing should be separated from those of other family members, as well. When a person has impetigo, it is common for them to get it a second time in the space of 6–9 months. This usually occurs in people aged 12–16.
was treated with an application of the antiseptic
gentian violet. Today, topical or oral antibiotic
s are usually prescribed. Treatment may involve washing with soap and water and letting the impetigo dry in the air. Mild cases may be treated with bactericidal ointment, such as fusidic acid
, mupirocin
, chloramphenicol or neosporin
, which in some countries may be available over-the-counter. More severe cases require oral antibiotics, such as dicloxacillin
, flucloxacillin
or erythromycin
. Alternatively amoxicillin
combined with clavulanate potassium, cephalosporins (1st generation) and many others may also be used as an antibiotic treatment.
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
l skin
Human skin
The human skin is the outer covering of the body. In humans, it is the largest organ of the integumentary system. The skin has multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs. Human skin is similar to that of most other mammals,...
infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
most common among pre-school children. People who play close contact sports such as rugby
Rugby football
Rugby football is a style of football named after Rugby School in the United Kingdom. It is seen most prominently in two current sports, rugby league and rugby union.-History:...
, American football
American football
American football is a sport played between two teams of eleven with the objective of scoring points by advancing the ball into the opposing team's end zone. Known in the United States simply as football, it may also be referred to informally as gridiron football. The ball can be advanced by...
and wrestling
Wrestling
Wrestling is a form of grappling type techniques such as clinch fighting, throws and takedowns, joint locks, pins and other grappling holds. A wrestling bout is a physical competition, between two competitors or sparring partners, who attempt to gain and maintain a superior position...
are also susceptible, regardless of age. Impetigo is not as common in adults. The name derives from the Latin
Latin
Latin is an Italic language originally spoken in Latium and Ancient Rome. It, along with most European languages, is a descendant of the ancient Proto-Indo-European language. Although it is considered a dead language, a number of scholars and members of the Christian clergy speak it fluently, and...
impetere ("assail"). It is also known as school sores.
Bullous impetigo
Bullous impetigo primarily affects infants and children younger than 2 years. It causes painless, fluid-filled blisterBlister
A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...
s — usually on the trunk, arms and legs. The skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
around the blister is usually red and itchy but not sore. The blisters, which break and scab
Scab
Scab can refer to the following:* Scab, a hard coating on the skin formed during the wound healing reconstruction phase* Derogatory term for a strikebreaker, a person who works despite strike action or against the will of other employees...
over with a yellow-colored crust, may be large or small, and may last longer than sores from other types of impetigo.
Ecthyma
Ecthyma is a more serious form of impetigo in which the infection penetrates deeper into the skin's second layer, the dermisDermis
The dermis is a layer of skin between the epidermis and subcutaneous tissues, and is composed of two layers, the papillary and reticular dermis...
. Signs and symptoms include:
- PainPainPain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
ful fluid- or pus-filled sores that turn into deep ulcers, usually on the legs and feet - A hard, thick, gray-yellow crust covering the sores
- Swollen lymph glands in the affected area
- Little holes the size of pinheads to the size of pennies appear after crust recedes
- ScarScarScars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
s that remain after the ulcers heal
Causes
It is primarily caused by Staphylococcus aureusStaphylococcus aureus
Staphylococcus aureus is a facultative anaerobic Gram-positive coccal bacterium. It is frequently found as part of the normal skin flora on the skin and nasal passages. It is estimated that 20% of the human population are long-term carriers of S. aureus. S. aureus is the most common species of...
, and sometimes by Streptococcus pyogenes
Streptococcus pyogenes
Streptococcus pyogenes is a spherical, Gram-positive bacterium that is the cause of group A streptococcal infections. S. pyogenes displays streptococcal group A antigen on its cell wall. S...
. According to the American Academy of Family Physicians
American Academy of Family Physicians
The American Academy of Family Physicians was founded in 1947 to promote the science and art of family medicine. It is one of the largest medical organizations in the United States, with over 100,000 members...
, both bullous and nonbullous are primarily caused by Staphylococcus aureus, with Streptococcus also commonly being involved in the nonbullous form."
Transmission
The infectionInfection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
is spread by direct contact with lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
s or with nasal
Human nose
The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...
carriers. The incubation period
Incubation period
Incubation period is the time elapsed between exposure to a pathogenic organism, a chemical or radiation, and when symptoms and signs are first apparent...
is 1–3 days. Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.
Diagnosis
Impetigo generally appears as honey-colored scabs formed from dried serumSerum
Serum may refer to:*Blood serum, a component of blood which is collected after coagulation.**Antiserum, blood serum with specific antibodies for passive immunity*Serous fluid, any clear bodily fluid*any drug derived from an animal's blood or serous fluid...
, and is often found on the arms, legs, or face.
Prevention
Good hygieneHygiene
Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...
practices can help prevent impetigo from spreading. Those who are infected should use soap
Soap
In chemistry, soap is a salt of a fatty acid.IUPAC. "" Compendium of Chemical Terminology, 2nd ed. . Compiled by A. D. McNaught and A. Wilkinson. Blackwell Scientific Publications, Oxford . XML on-line corrected version: created by M. Nic, J. Jirat, B. Kosata; updates compiled by A. Jenkins. ISBN...
and water to clean their skin and take baths or showers regularly. Non-infected members of the household should pay special attention to areas of the skin that have been injured, such as cuts, scrapes, insect bites, areas of eczema
Eczema
Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...
, and rash
Rash
A rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
es. These areas should be kept clean and covered to prevent infection. In addition, anyone with impetigo should cover the impetigo sores with gauze and tape. All members of the household should wash their hands thoroughly with soap regularly. It is also a good idea for everyone to keep their fingernails cut short to make hand washing more effective. Contact with the infected person and his or her belongings should be avoided, and the infected person should use separate towels for bathing and hand washing. If necessary, paper towels can be used in place of cloth towels for hand drying. The infected person's bed linens, towels, and clothing should be separated from those of other family members, as well. When a person has impetigo, it is common for them to get it a second time in the space of 6–9 months. This usually occurs in people aged 12–16.
Treatment
For generations, the diseaseDisease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
was treated with an application of the antiseptic
Antiseptic
Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction...
gentian violet. Today, topical or oral antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
s are usually prescribed. Treatment may involve washing with soap and water and letting the impetigo dry in the air. Mild cases may be treated with bactericidal ointment, such as fusidic acid
Fusidic acid
Fusidic acid is a bacteriostatic antibiotic that is often used topically in creams and eyedrops, but may also be given systemically as tablets or injections...
, mupirocin
Mupirocin
Mupirocin is an antibiotic originally isolated from Pseudomonas fluorescens NCIMB 10586, developed by Beecham....
, chloramphenicol or neosporin
Neosporin
Neosporin is the product branding & formulas now owned by Johnson & Johnson of an antibiotic over-the-counter topical created under Warner-Lambert Consumer Healthcare, now a part of Pfizer...
, which in some countries may be available over-the-counter. More severe cases require oral antibiotics, such as dicloxacillin
Dicloxacillin
Dicloxacillin is a narrow-spectrum beta-lactam antibiotic of the penicillin class. It is used to treat infections caused by susceptible Gram-positive bacteria. It is active against beta-lactamase-producing organisms such as Staphylococcus aureus, which would otherwise be resistant to most...
, flucloxacillin
Flucloxacillin
Flucloxacillin or floxacillin is a narrow-spectrum beta-lactam antibiotic of the penicillin class. It is used to treat infections caused by susceptible Gram-positive bacteria. Unlike other penicillins, flucloxacillin has activity against beta-lactamase-producing organisms such as Staphylococcus...
or erythromycin
Erythromycin
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and...
. Alternatively amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...
combined with clavulanate potassium, cephalosporins (1st generation) and many others may also be used as an antibiotic treatment.
External links
- Impetigo Pictures — Pictures of Impetigo caused by Staph Infections and MRSA.
- NIH/Medline
- Photo (University of Iowa)
- Dermnet NZ