impetigo

What is it ?

Impetigo is a skin infection caused by a bacteria called staphylococcus aureus. It is common in toddlers and school aged children during the summer months.  This bacteria gets into the skin and results in a sores and blisters. This sore will be heavily infected and scratching will transfer this infection to other parts of the body. Impetigo occurs after an insect bite or an episode of dermatitis or eczema. Another less common organism called streptococcus pyogenes can also cause a similar kind of skin infection. The treatment is the same. Occasionally this bacteria can cause a rare and serious kidney disorder called glomerulonephritis.

What is the treatment ?

Treating the infection requires eradicating the bacteria from the sores using antibiotics. These are either taken orally or are administered in a ointment or cream. Take the medication as prescribed and keep the sores clean and covered to prevent spreading. In addition fingernails need to be cleaned and trimmed to prevent recurrence. While the infection is healing, gently wash the areas of infected skin with clean gauze and antiseptic soap everyday. To keep from spreading place the antiobiotic ointment on and cover with a dressing.

Is it contagious ?

To 'catch' impetigo there needs to be direct contact with the infected sores. The child with impetigo will also commonly have the bacteria under the finger nails and on clothing. It is not transmitted in saliva or coughing or in bowel actions.

Preventing Spread

• Separately wash clothes and bedding
• Regular handwashing and keeping fingernails trimmed
• Regular showering with an antibacterial soap.

What about complications ?

1. Occasionally if not treated the infection can spread to the deeper tissues and cause an abscess. This can be serious if not treated.
2. A rare complication following infection with the bacteria streptococcus is a kidney disease called glomerulonephritis. This is where the kidneys fail to properly manage the biochemistry of the body, the blood pressure and allow blood and protein into the urine. This used to be a common problem and occurs after streptococcus infection of either the throat or the skin. Nowadays for a variety of complex reason this is rare in urban Australia.  

What about recurrent infections ?

In some instances, people will have multiple recurrent staphylococcus infections. This is usually due to long term carriage of the organism in places that the antibiotics cannot reach. This includes the nasal passage, the fingernails and under the arms in adolescents. If there is recurrent infection then treating these areas is important

• For the nose 2-3 times per month place some antibiotic ointment across the entrance of the nasal passage. This is especially advised for this nose pickers.
• For the fingernails make sure they are trimmed and clean and the ointment can be scraped under the fingernails at the same time as the nose.
• Similarly for the older adolescents use a cleaning solution called clindatech to try and eradicate under the arms.

There is little evidence that recurrent infections are due to a weakness in the immune system or some lack in vitamins or minerals.