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Impetigo

DEFINITION:

Infection of the skin.

SYMPTOMS:

Crusting, oozing, itching and swollen glands near the rash.

CAUSES:

Streptococcus or staphylococcus bacteria.

OUTCOME:

Usually excellent. However, rarely impetigo can cause complications, which include cellulitis (or soft tissue infection), osteomyelitis (or bone infection) septic arthritis (or joint infection), sepsis (or bacteria in the bloodstream), or kidney disease, such as poststreptococcal glomerulonephritis, which can be a residual complication from having a strept infection in the past.

CONTAGION:

Impetigo is contagious until treatment has been ongoing for 24 hours. The incubation period is 2 to 5 days.

TREATMENT AND DISCUSSION:

Impetigo usually begins because a breakage in the skin allows bacteria to penetrate below the skin barrier. This breakage in the skin is usually from trauma (a cut or abrasion), chicken pox, burns or insect bites. Once the bacteria invades the skin, it spreads, causing crusting, oozing or itching. This can then spread to other parts of the body. If it is left untreated, impetigo will typically resolve without complications. The complications that do occur are very rare. Since impetigo is contagious, it is best to treat the child so that the child is no longer contagious to other children. Treatment can be with an antibiotic, either orally or topically. Once the antibiotic is started, the child will be contagious for another 24 hours. The antibiotic should be continued for another 7 to 10 days to insure complete resolution.

ONE DOCTOR'S OPINION:

Impetigo is one of the more common reasons for children to go their physicians for a rash. According to Nelson's Textbook of Pediatrics, it accounts for 17% of all visits for rash. I typically use a topical cream or ointment such as Neosporin or mupirocin (Bactroban), but in worse cases I will use an oral antibiotic or both. Once therapy is started, healing occurs rapidly. The contagious period ends after 24 hours of treatment, but if the medicine is not continued for 7 for 10 days, it can relapse, so be sure to complete the whole course of antibiotic treatment.