• Monday July 13,2020

Impetigo contagiosa

The Impetigo contagiosa is a highly contagious bacterial infectious disease that occurs especially in neonatal and childhood. The infection can occur in principle in every age group. Synonyms are pus, lichen, bark lichen or train. Mostly the face and extremities are affected.

What is an impetigo contagiosa?

If the child shows symptoms of a skin disease, it should go the same day with him to the pediatrician. External signs such as pus, yellowish crusts or redness indicate that it is impetigo contagiosa - a condition that must be treated by a doctor in any case.
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Impetigo contagiosa is one of the bacterial infections of the skin. It is common and highly contagious. Although the infection may affect all ages, children and newborns are most commonly affected.

There are two forms of impetigo contagiosa that cause different bacteria. The small-bubble form is triggered by group A beta-hemolytic streptococci. The causative agent of the large-bubble form is the Staphylococcus aureus.

The incubation period is two to ten days. There is a risk of infection as long as open, purulent skin has not yet healed. During this time, the bubbles or their contents are highly contagious.

causes

The impetigo contagiosa is transmitted by a smear infection with the bacteria mentioned. The bacteria are also in many healthy people in the nose and throat area.

The disease occurs when the pathogen can penetrate into the bloodstream through scratched or injured skin and destroy tissue there. Therefore, for example, children with eczema, chickenpox or scabies are particularly susceptible to impetigo contagiosa.

The bacteria are transmitted by direct contact or contaminated hands (smear infection). They also survive longer periods on glasses or other objects. Thus, an indirect transmission is possible if a contaminated object is used by several people. Of course, the infection spreads easily in community facilities such as school or kindergarten.

Symptoms, complaints & signs

The three forms of impetigo contagiousness are characterized by predominantly uniform symptoms. Typical are the small, white to reddish blisters on the skin. These lesions, which in the non-bullous form are very small and therefore scarcely visible, burst after some time, and yellowish crusts form.

Then there is often an itching. The bubbles can occur punctually or over a large area. A severe attack affects a large part of the skin. In small-bladder impetigo contagiosa, the blisters are small and filled with pus, and burst due to their thin skin after a few days. The large-bladder impetigo contagiosa manifests itself by major skin changes with a thicker skin.

They are clear at the beginning and slowly diminish. The bubbles burst after one to two weeks and leave behind the characteristic encrustation. The non-bullous impetigo contagiosa produces few or no vesicles, although yellowish crusts still occur. In rare cases, a change in the skin causes a fever. The increased body temperature is associated with typical signs of illness such as chills and discomfort and stops after a few days.

Diagnosis & History

The doctor can make a diagnosis of impetigo contagiosa based on a gaze diagnosis, since the rash is disease typical. In addition, a skin smear (also smear of the nose and throat) is possible to detect the pathogen in case of doubt. Differential diagnosis excludes the doctor from a herpes simplex infection.

The rash in impetigo contagiosa is typical. The patient shows golden yellow, red edged crusts, which occur mainly in the area of ​​the mouth and nose and on the hands.

First, the skin is slightly red and it forms bubbles that are filled with fluid or pus. In the small bubble shape, the wall of the bubbles is very thin and bursts quickly. As a result, the disease-typical honey-yellow scab forms.

In large-bladder impetigo contagiosa, the patient may also develop fever and show lymph node swelling. The fluid of the blisters is highly contagious. Crust formation is more pronounced in the small bubble form than in the large bubble impetigo contagiosa.

Finally, the dander fall off by itself or can be removed by hand. With consistent therapy and compliance with hygienic regulations, the infection usually heals without consequences.

However, complications may also occur during the illness. Thus, the patient may develop postinfectious glomeronephritis, lymphadenitis or regional lymphangitis.

complications

The impetigo contagiosa causes mainly discomfort to the extremities and face of the patient. In most cases, blisters develop on the skin and the person suffering from a severe rash. This rash may itch and it may also form blisters filled with pus.

Patients' quality of life is significantly reduced by impetigo contagiosa, and there is often a reduction in self-esteem due to aesthetic limitations. Not infrequently sufferers also suffer from inferiority complexes and depression. They withdraw from social life and also suffer from a strong exhaustion.

It can also lead to swelling of the lymph nodes and the formation of fever. The affected person also suffers from a reduced resilience. In the treatment of impetigo contagiosa there are no further limitations or complications.

This usually takes place with the help of antibiotics and leads relatively quickly to a positive disease course. The life expectancy of the patient is not limited by the disease. However, scars can develop in severe cases.

When should you go to the doctor?

If the child shows symptoms of a skin disease, it should go the same day with him to the pediatrician. External signs such as pus, yellowish crusts or redness indicate that it is impetigo contagiosa - a condition that must be treated by a doctor in any case. Parents who notice symptoms in their child, consult the dermatologist immediately. This is especially true when the child complains of increasing pain and itching.

At the latest, if the bubbles open or even ignite, the child must be medically treated. Children who have recently had chickenpox or scabies or who suffer from atopic dermatitis are particularly prone to impetigo contagiosa. Parents should see a doctor if the symptoms mentioned are related to any of these conditions. In case of severe symptoms, the child should be taken to hospital. The further treatment is carried out by the dermatologist or an internist.

Treatment & Therapy

Because of possible sequelae, the doctor treats impetigo contagiosa in severe cases systemically with antibiotics (amoxicillin or flucoxacillin).

The doctor also prescribes antibiotic-containing ointments such as fusidic acid, mupirocin or retapamulin for the affected skin areas. Baths and envelopes with disinfecting solutions are also helpful.

Outlook & Forecast

With expert treatment, the prospects for curing impetigo contagiosa are very good. The bark braid often heals spontaneously again. Nevertheless, those with an impetigo contagiosa should not wait to see if this happens. It is safer to start treatment of the infection and to prevent the spread of bark lichen to other areas of the skin. Even with medical treatment, it can take weeks for all the signs of the lichen to disappear.

The affected skin areas later show purulent pustules that open quickly and leave yellow crusts. This is not only unpleasant, but also contagious. Therefore, the infection will spread if the person concerned does not take them seriously enough and abducted by misconduct germs.

The spread of impetigo contagiosa to other skin areas may well lead to complications. In purulent conjunctivitis (conjunctivitis) the eyes are affected, in the middle ear inflammation (otitis media) the ears. In addition, glomerulonephritis may occur on longer courses. This worsens the prognosis.

Depending on whether staphylococci or streptococci have triggered impetigo contagiosa, further consequences may occur in the case of an untreated infection. Staphylococci, for example, can cause sepsis or inflammation of the lymphatics. Untreated streptococcal infections can cause kidney damage such as post-infectious glomerulonephritis.

prevention

A spread can only be prevented by consistent compliance with all hygienic measures. The patient should under no circumstances scratch the highly infectious blisters. In the case of children, parents can therefore cut the fingernails as short as possible.

Regular hand washing of the patient and, of course, all contact persons is essential. All clothing worn by the patient and all used towels and bed linen must be cooked at 60 ° C.

Thus, the infection can be contained and spread can be prevented. In order to prevent infection of other people, the patient may visit community facilities such as schools or kindergartens only when the infected skin has healed completely. This is the case when the crusts have completely fallen off.

aftercare

In Impetigo contagiosa the person concerned in most cases have no special options for aftercare available. The sooner the illness is recognized, the better is therefore usually the further course, so that the affected person should ideally consult a doctor at the first symptoms and symptoms. A self-healing can not occur in impetigo contagiosa.

In most cases, the treatment of the disease takes place by taking different medications. If antibiotics are administered, the person concerned should not take them together with alcohol, as otherwise their effect is significantly alleviated. It is also important to ensure a regular intake and also to a correct dosage.

In case of ambiguity or questions always consult a doctor first. Furthermore, as a rule, no special measures are necessary. The Impetigo contagiosa does not reduce the life expectancy of the person affected. The patient should, however, spare and rest. Efforts or stressful activities should definitely be foreseen so as not to burden the body unnecessarily.

You can do that yourself

In case of impegno contagiose, a medical treatment is required in any case. Medical therapy can be supported by some self-help measures and various household and natural resources.

The most important measure is to replace the crusts twice a day. For this purpose, an antiseptic solution is needed, which softens the encrustations and thus prevents injuries to the skin. Subsequently, the wound can be treated with an antiseptic ointment or a local antibiotic and closed with a fresh bandage. When removing the crusts, care must be taken to ensure thorough hygiene, otherwise inflammation may occur. If larger areas of the skin are affected, disinfectant baths containing quinolinol or potassium permanganate are recommended. In the case of a chronic course, treatment with antibiotics is required.

Both medical preparations and strict hygiene measures help against the itching. Those affected should wash their hands frequently and thoroughly and not bathe with other family members or with the partner. In addition, the fingernails should be cut regularly and the towels should be washed hot after use. Patients should have a sick leave for at least one to two weeks. Only when the doctor gives the all-clear, may again direct physical contact be taken with other people.


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