Not stringently used term for a superficial, purulent, contagious, non follicularly bound, bacterial skin infection caused predominantly by coagulase-positive staphylococci (mostly phage group II, phage type 71) in < 10% by haemolytic group A streptococci (Streptococcus pyogenes). Mixed infections with both pathogens are rarer. The infection preferentially affects children.
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Impetigo (overview)L01.1
DefinitionThis section has been translated automatically.
ClassificationThis section has been translated automatically.
A distinction is made:
- Non bullous impetigo (Remark: This term is synonymous with contagious small bullous impetigo).
- Bullous impetigo
EtiopathogenesisThis section has been translated automatically.
Smear infection through direct physical contact, less frequently via contaminated objects. Nasal and perineal infections with Staphylococcus aureus should also be considered as a source of infection.
ManifestationThis section has been translated automatically.
Ubiquitous pyoderma, which occurs mainly in children between 2 and 5 years of age. Most common bacterial disease in children. It is not uncommon for the infection to be preceded by a rhinitis (pre-damage to the skin through nasal secretions).
HistologyThis section has been translated automatically.
Subcorneal bladder or pustule with single or mass neutrophil leukocytes.
DiagnosisThis section has been translated automatically.
Swab from blisters or pustules and bacterial culture on blood agar. Gram staining (Gram-positive cocci).
TherapyThis section has been translated automatically.
In case of itching, a sedative antihistamine is recommended, e.g. Clemastine (Tavegil Syrup 2-4 teaspoons/day), Dimetinden (e.g. Fenistil Syrup 3-6 teaspoons) or the non-sedative Desloratadin (e.g. Aerius Syrup 1/2-1 measuring spoon).
External therapyThis section has been translated automatically.
Internal therapyThis section has been translated automatically.
Antibiosis after antibiogram with beta-lactamase-resistant antibiotics, e.g. cephalosporins
ProphylaxisThis section has been translated automatically.
In case of recurrent infections, rehabilitation of chronic germ carriers (nose, perianal)!
TablesThis section has been translated automatically.
Antibiotic therapy for contagious impetigo
Pathogen |
antibiotic |
Example preparation |
Daily dosages |
Unit |
|||||
Age in years | |||||||||
|
|
|
¼ |
½ |
1 |
3 |
7 ½ |
12 |
|
|
|
|
Average body weight (kg) |
|
|||||
|
|
|
5,5 |
7,5 |
10 |
14 |
24 |
38 |
|
penicillin-sensitive Streptococci (MHK < 0.1 μg/ml) |
Penicillin V |
Isocillin |
0,3 |
0,36 |
0,45 |
0,6 |
0,9 |
1,2 |
million IU |
For penicillin intolerance: Erythromycinethylsuccinate |
Sanasepton forte |
250 |
300 |
375 |
500 |
750 |
1000 |
mg |
|
Staphylococci |
Dicloxacillin |
InfectoStaph |
330 |
400 |
500 |
670 |
1000 |
1330 |
mg |
Flucloxacillin |
Staphylex |
170 |
200 |
250 |
330 |
500 |
670 |
mg |
|
Note(s)This section has been translated automatically.
The term "impetigo" is not used uniformly in international literature. Older works also refer to pustular, non-bacterial skin diseases such as " Impetigo herpetiformis" or " Impetigo scabida". The term impetigo is often used synonymously with pyoderma or bacterial folliculitis (see below: ostiofolliculitis). Secondary, bacterial, purulent superimposed skin diseases are called impetiginized (see below impetiginization).