Impetigo
Disease Details
Family Health Simplified
- Description
- Impetigo is a highly contagious bacterial skin infection characterized by red sores, blisters, and honey-colored crusts, primarily affecting young children.
- Type
- Impetigo is a bacterial skin infection primarily caused by Staphylococcus aureus or Streptococcus pyogenes. It is not a genetic disease and therefore has no type of genetic transmission. It is typically spread through direct contact with an infected person or via contact with contaminated surfaces.
- Signs And Symptoms
-
Signs and symptoms of impetigo include:
- Red sores or blisters, primarily around the nose and mouth
- Sores that burst and develop honey-colored crusts
- Itching around the affected areas
- Oozing and formation of a yellow-brown crust
- Swollen lymph nodes near the infection sites in more severe cases
Impetigo is a highly contagious bacterial skin infection, often affecting young children. - Prognosis
- Without treatment, individuals with impetigo typically get better within three weeks. Complications may include cellulitis or poststreptococcal glomerulonephritis. Rheumatic fever does not appear to be related.
- Onset
- Impetigo typically begins with the appearance of red sores or blisters, usually around the nose and mouth. These sores can develop into pustules that burst and form a yellowish crust. The onset can occur rapidly within a few days of exposure to the bacteria causing the infection, which are usually Staphylococcus aureus or Streptococcus pyogenes.
- Prevalence
- Impetigo is a common bacterial skin infection, primarily caused by Staphylococcus aureus or Streptococcus pyogenes. It predominately affects children between the ages of 2 and 5 years but can technically occur in individuals of any age. The exact prevalence can vary widely based on factors like geography, climate, and socioeconomic status. Generally, impetigo is more prevalent in warm, humid climates.
- Epidemiology
- Globally, impetigo affects more than 162 million children in low- to middle-income countries. The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania. The tropical climate and high population in lower socioeconomic regions contribute to these high rates. Children under the age of 4 in the United Kingdom are 2.8% more likely than average to contract impetigo; this decreases to 1.6% for children up to 15 years old. As age increases, the rate of impetigo declines, but all ages are still susceptible.
- Intractability
- Impetigo is not considered intractable. It is typically a superficial bacterial skin infection that is highly treatable with appropriate antibiotics. Most cases resolve without complications when treated properly. Early diagnosis and suitable medical intervention can effectively manage and cure the condition.
- Disease Severity
- Impetigo is generally a mild condition, but it can vary in severity. It often presents as red sores or blisters that can rupture, ooze, and form a yellow-brown crust. While it's more common in children, it can affect individuals of all ages. If untreated, it can sometimes lead to complications such as cellulitis, kidney inflammation, or scar formation. Prompt medical treatment typically resolves the condition effectively.
- Healthcare Professionals
- Disease Ontology ID - DOID:8504
- Pathophysiology
- Impetigo is a superficial bacterial skin infection primarily caused by Staphylococcus aureus and, less frequently, by Streptococcus pyogenes. The pathophysiology involves the bacteria entering through minor breaks or cuts in the skin, leading to infection. Once the bacteria invade, they produce toxins that disturb the skin’s barrier function. This results in the formation of characteristic honey-colored crusts primarily seen on the face and extremities. The infection is highly contagious and can spread through direct contact with lesions or contaminated objects.
- Carrier Status
- Impetigo is a highly contagious bacterial skin infection. Carrier status for impetigo typically involves individuals who harbor the causative bacteria (Staphylococcus aureus or Streptococcus pyogenes) in their nose or on their skin without showing symptoms themselves. Interventions may be necessary to eradicate the bacteria from carriers to prevent the spread of infection.
- Mechanism
-
Impetigo is a highly contagious skin infection primarily caused by Staphylococcus aureus and Streptococcus pyogenes bacteria.
**Mechanism:**
The infection typically begins when the bacteria penetrate the skin through minor cuts, insect bites, or other breaks in the skin barrier. It is characterized by the formation of red sores or blisters that can burst, leading to the formation of a yellowish-brown crust. Impetigo mainly affects children and is spread through direct contact with an infected person or contaminated objects.
**Molecular Mechanisms:**
1. **Bacterial Adhesion and Colonization:**
- S. aureus and S. pyogenes express surface proteins that facilitate adhesion to skin cells. For instance, S. pyogenes utilizes protein F and lipoteichoic acid to bind to fibronectin on host cells, while S. aureus uses surface adhesins such as MSCRAMMs (Microbial Surface Components Recognizing Adhesive Matrix Molecules).
2. **Toxin Production:**
- S. aureus produces exfoliative toxins (ETs), specifically ETA and ETB, which target desmoglein-1, a key protein in epidermal cell adhesion. The cleavage of desmoglein-1 leads to the loss of cell-to-cell adhesion, resulting in blister formation.
- S. pyogenes produces streptococcal pyrogenic exotoxins (SPEs) and other enzymes that can damage host tissues and evade the immune response.
3. **Immune Evasion:**
- Both bacteria have evolved mechanisms to evade the host immune system. S. aureus employs proteins such as Protein A, which binds to the Fc portion of antibodies, preventing phagocytosis.
- S. pyogenes uses the M protein to inhibit phagocytosis and complements activation.
4. **Biofilm Formation:**
- Both pathogens can form biofilms, complex communities of bacteria embedded in a protective matrix. This enhances their survival on the skin and resistance to antibiotic treatment.
Understanding these mechanisms highlights the complexity of bacterial infections and the need for targeted therapeutic strategies to effectively treat impetigo. - Treatment
-
Antibiotics, either as a cream or by mouth, are usually prescribed. Mild cases may be treated with mupirocin ointments. In 95% of cases, a single seven-day antibiotic course results in resolution in children. It has been advocated that topical antiseptics are inferior to topical antibiotics, and therefore should not be used as a replacement. However, the National Institute for Health and Care Excellence (NICE) as of February 2020 recommends a hydrogen peroxide 1% cream antiseptic rather than topical antibiotics for localised non-bullous impetigo in otherwise well individuals. This recommendation is part of an effort to reduce the overuse of antimicrobials that may contribute to the development of resistant organisms such as MRSA.
More severe cases require oral antibiotics, such as dicloxacillin, flucloxacillin, or erythromycin. Alternatively, amoxicillin combined with clavulanate potassium, cephalosporins (first-generation) and many others may also be used as an antibiotic treatment. Alternatives for people who are seriously allergic to penicillin or infections with methicillin-resistant Staphococcus aureus include doxycycline, clindamycin, and trimethoprim-sulphamethoxazole, although doxycycline should not be used in children under the age of eight years old due to the risk of drug-induced tooth discolouration. When streptococci alone are the cause, penicillin is the drug of choice. When the condition presents with ulcers, valacyclovir, an antiviral, may be given in case a viral infection is causing the ulcer. - Compassionate Use Treatment
- Compassionate use treatment for impetigo may include investigational antibiotics or therapies not yet widely available, used in severe or resistant cases when standard treatments fail. Off-label or experimental treatments could involve the use of newer topical or systemic antibiotics that are not traditionally prescribed for impetigo, or the application of antiseptic measures and novel pharmacological strategies aimed at improving wound healing and reducing bacterial load. Always consult a healthcare provider for guidance on the most appropriate treatment options.
- Lifestyle Recommendations
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### Lifestyle Recommendations for Impetigo
1. **Maintain Good Hygiene:**
- Wash affected areas with mild soap and water.
- Keep nails trimmed and clean to prevent the spread of bacteria.
2. **Avoid Scratching:**
- Refrain from scratching lesions to prevent spreading and secondary infections.
- Consider using mittens or gloves for children if necessary.
3. **Isolate the Infected Person:**
- Keep the affected individual away from close contact with others, especially infants, elderly, and those with compromised immune systems.
- Avoid sharing towels, clothing, and bedding.
4. **Cover Lesions:**
- Use loose-fitting, clean clothing to cover lesions.
- Applying non-stick bandages can help prevent spreading bacteria.
5. **Regular Cleaning:**
- Disinfect common surfaces such as doorknobs, bathroom fixtures, and toys.
- Wash laundry separately and use hot water with detergent.
6. **Healthy Diet:**
- Encourage a balanced diet to support the immune system.
- Stay hydrated and consume foods rich in vitamins and minerals.
7. **Hand Hygiene:**
- Wash hands frequently with soap and water, especially after touching the infected area.
- Use hand sanitizer if soap and water are not available.
8. **Avoid Close Contact Activities:**
- Suspend sports and activities that involve skin-to-skin contact until the infection clears up.
### Note:
- Seek medical advice for appropriate treatment, including the use of topical or oral antibiotics if prescribed. - Medication
- Impetigo is typically treated with topical or oral antibiotics. Topical antibiotics such as mupirocin or fusidic acid are commonly prescribed for mild cases. For more extensive or severe cases, oral antibiotics like dicloxacillin or cephalexin may be used. Always consult a healthcare professional for proper diagnosis and treatment.
- Repurposable Drugs
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Impetigo is a bacterial skin infection, primarily caused by Staphylococcus aureus or Streptococcus pyogenes. While specific drugs may be repurposed, commonly used medications include:
1. **Mupirocin (topical antibiotic):** Often prescribed for localized impetigo.
2. **Retapamulin (topical antibiotic):** Another option for topical treatment.
3. **Systemic antibiotics:** In more severe cases, oral antibiotics such as cephalexin, dicloxacillin, or clindamycin may be used.
Repurposable drugs might involve other antibiotics not initially intended for impetigo but effective against similar bacterial infections. Always consult a healthcare provider for appropriate treatment. - Metabolites
- Impetigo is a bacterial skin infection, typically caused by Staphylococcus aureus or Streptococcus pyogenes. However, comprehensive data on specific metabolites associated strictly with impetigo is limited or not well-defined in studies. The primary focus of research and treatment for impetigo revolves around eradicating the bacterial infection and managing symptoms rather than metabolite analysis.
- Nutraceuticals
- For impetigo, there is limited evidence on the efficacy of nutraceuticals. Conventional treatment typically involves topical or oral antibiotics. However, maintaining a healthy immune system through a balanced diet that includes vitamins and minerals like Vitamin C, Zinc, and Omega-3 fatty acids might support overall skin health and immune response. It's essential to consult a healthcare professional before considering nutraceuticals as part of the treatment plan.
- Peptides
- Impetigo is a highly contagious bacterial skin infection primarily caused by Staphylococcus aureus or Streptococcus pyogenes. There is ongoing research into the development of peptide-based treatments for impetigo, focusing on antimicrobial peptides (AMPs) that could potentially target and kill the bacteria responsible for the infection. Nanotechnology applications, such as nanoparticle carriers, are also being explored to enhance the delivery and efficacy of antimicrobial agents in treating impetigo.