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Impetigo

Child Infection Basics

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Updated July 16, 2014

Pediatrician Examining a Girl s Rash
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Impetigo is a bacterial skin infection.

Impetigo Symptoms

Children with impetigo usually develop honey colored crusted lesions, usually beginning in areas where the skin has been broken, irritated or damaged. The nostrils, especially in kids with a runny nose, are commonly affected. Untreated infections can quickly spread to other areas on the child's body.

Bullous impetigo cause much larger skin lesions that look like blisters that quickly rupture and commonly affects a child's trunk or buttocks.

Diagnosis of Impetigo

Although bacterial cultures can be done, diagnosis is usually based on the typical appearance of the rash.

Bacterial cultures are helpful if your Pediatrician suspects that your child's impetigo is being caused by a resistant bacteria, such as MRSA, methicillin resistant staph aureus, or if he simply has a rash that isn't going away.

Impetigo Treatments

For small areas of infection, an over-the-counter or prescription strength topical antibiotic may be all that is needed, in addition to washing the area with warm soapy water. For more extensive or persistent infections, an oral or intravenous antibiotic might be needed.

With the increased rates of community acquired MRSA, a bacteria that is resistant to many of the antibiotics that are commonly used to treat impetigo, including Keflex, Duricef, Augmentin, Zithromax, and Omnicef, stronger antibiotics are often needed to treat these infections. These antibiotics typically include Clindamycin and Bactrim.

What You Need To Know

  • The most common strains of bacteria that cause impetigo include group A beta-hemolytic streptococci (GABHS) and Staphylococcus aureus.

  • Impetigo is spread by direct contact with infected lesions. Children are usually no longer contagious once they have been on antibiotics for 24-48 hours and there is no longer a discharge or you are seeing signs of improvement.

  • The S. aureus bacteria commonly lives on or colonizes the skin of children and adults. It is especially common to find it in the nose, which can make it easily spread as children pick their nose.

  • Keep bites, scrapes, and rashes clean and covered and apply a triple antibiotic to them three times a day to prevent them from getting infected by the staph bacteria.

  • To get rid of staph colonization, it can sometimes help to treat all family members with mupirocin (Bactroban) nasal gel twice a day for 5-7 days, daily Hibiclens (an Antiseptic, Antimicrobial Skin Cleanser) baths, and encourage very frequent handwashing.

  • Folliculitis is a similar infection that involves hair follicles

  • Glomerulonephritis, which can cause hematuria (bloody urine) and high blood pressure, is a rare complication of having impetigo.



References:
1Habif: Clinical Dermatology, 4th ed., Copyright © 2004 Mosby, Inc.
2 Long: Principles and Practice of Pediatric Infectious Diseases, 2nd ed., Copyright © 2003 Churchill Livingstone, An Imprint of Elsevier

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