By Gary M. White, MD
Impetigo is a cutaneous infection usually caused by either Staphylococcus aureus or Streptococcus pyogenes or both.
- This bacterial infection is more common in children and may be preceded by trauma, a bug bite, chickenpox or be secondary to atopic dermatitis.
- Crusting, erosions and thin-walled blisters are typical.
- See also bullous impetigo.
Clinically, one sees red, crusted areas, often of the face, but nearly any location may be affected. Children commonly develop impetigo about the nose and mouth. Honey-colored crust, pustules or bulla may be seen. Bullous impetigo is usually caused by staph.
- Perform gram stain and culture to distinguish between staphylococcus aureus and beta-hemolytic streptococcus-associated infections.
- Treat topically with either mupirocin or retapamulin (topical ointment twice daily for 5 days), or
- Give an oral antibiotic, e.g., dicloxacillin or cephalexin for 7 days for methicillin-susceptible S. aureus; doxycycline, clindamycin, or sulfamethoxazole-trimethoprim if methicillin-resistant S. aureus is suspected.
- From Clin Infect Dis 2014 Jul 15; 59:e10
A high school student developed a diffuse red, scaly rash on the arms.
Close examination showed thin-walled pustules. Culture grew out Staphylococcus aureus.
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