neonatal pustulosis
Introduction
Introduction to neonatal impetigo Neonatal pustulosis (impetigoneonatorum), also known as neonatal bullous impetigo (bullousimpetigoofthenewborn) or neonatal pemphigus (pemphigusneonatorum), is a common neonatal infectious pancreatic skin The disease is acute and contagious. Mainly Staphylococcus aureus infection, the most common type of Staphylococcus aureus group II 71, followed by 80/81 type. Most of the pathogens are from the staff of the baby room, the mother or the family, etc., followed by the diaper or bed sheets and other disinfection is not strict and lead to pollution. basic knowledge The proportion of illness: 0.002% Susceptible people: young children Mode of infection: contact infection Complications: diarrhea, pneumonia, nephritis, meningitis, sepsis
Cause
Causes of neonatal impetigo
Pathogen infection (60%):
Positive by coagulase, phage II group 71 type Staphylococcus aureus contact infection, because the baby's skin is tender, weak resistance, and because of the newborn's first contact with bacteria, especially sensitive to bacteria, plus wrapped with plastic cloth, days Hot and sweaty, so that local skin temperature, high humidity, skin is easy to be impregnated, causing good conditions for the invasion and reproduction of suppurative bacteria. Neonatal impetigo are often transmitted from maternal, midwifery and mother, and some are assisted The person is a carrier, and in the baby room, the nursing room, once the disease is found, it must be strictly disinfected and isolated.
Pathogenesis
The pathogenic bacteria are mostly from the medical staff of the bacteria or the mother of the child. They are mainly transmitted through contact. The newborn's skin is delicate, the immune function is incomplete, and it is particularly sensitive to bacteria, especially malnutrition, hot and humid climate, excessive warmth, and skin sweating. Induced this disease.
Prevention
Neonatal impetigo prevention
It is strictly forbidden for medical staff and family members with suppurative skin diseases to contact newborns. Non-workers are strictly forbidden to enter the baby room. The children should be isolated immediately. Pay attention to the cleanliness of newborns, diapers for children, clothes should be disinfected frequently, and baby indoors should be noted. Ventilation and heat dissipation, regular disinfection.
(1) Wash your hands with soap and running water before caring for newborns. Newborns should bathe frequently, change clothes frequently, clothes should be soft, avoid skin damage, and don't let children overheat, get too much, and ventilate indoors in summer. .
(2) Carry out hygienic publicity, towels, basins, etc. should be disinfected frequently.
(3) Pay attention to cleanliness, ban plastic sheets and diapers.
Complication
Neonatal impetigo complications Complications diarrhea pneumonia nephritis meningitis sepsis
At the beginning of the disease, the systemic symptoms are not obvious. As the disease progresses, fever, diarrhea, pneumonia, nephritis, meningitis and even sepsis may occur, resulting in death of the child.
Symptom
Newborn pustulosis symptoms common symptoms pustular diarrhea diarrhea meningitis sepsis
More than 4 to 10 days after the birth of the baby, the infection is strong, easy to be popular in obstetrics, baby room or breastfeeding room, starting from the red tip of the needle tip to the bean, the blisters appear rapidly, the blisters rapidly expand, from the pea to Walnuts are larger or larger, and there is an inflammatory blush around the blister. The blister is thin and easy to break. After a day or two, the liquid in the bulls becomes cloudy, or the blister is first yellow pus, but the whole bullae are mostly suppurated. The blister is very full first, and then expands and relaxes. After the rupture of the blister, it reveals flushing, smooth smashed surface, and later forms a thin sputum. Blisters can appear elsewhere, which can be smashed like a general pemphigus. Mostly occur in the exposed parts of the face, hands, etc., can also occur in the trunk and limbs, and the palmar stenosis is often not damaged, and sometimes the damage also occurs on the mucous membrane or affects the fingers and causes suppurative nail bed inflammation or paronychia. At the beginning of the disease, the systemic symptoms are not obvious. As the disease progresses, fever, diarrhea, pneumonia, nephritis, meningitis and even sepsis may occur, resulting in death of the child.
Examine
Examination of neonatal impetigo
1, blood, urine routine examination, take pus or exudate for bacterial culture and drug sensitivity test, such as suspected sepsis, should be blood culture, new blister content bacterial culture can be seen pathogenic bacteria.
2, for the epidermis under the keratin, the blister contains a large number of neutrophils and cocci, the sacral spine layer has a sponge formation and a large number of inflammatory cell infiltration, the upper dermis is non-specific inflammatory changes.
Diagnosis
Diagnosis and diagnosis of neonatal impetigo
Differential diagnosis
According to the characteristics of neonatal pustulosis with large pustules followed by systemic symptoms, it can be diagnosed, but with the following diseases:
1, gold grape scald skin syndrome may be a serious type of this disease, acute onset, severe systemic symptoms, skin lesions are mainly large blisters, Nie's sign positive, exfoliation is significant, without large pustule damage.
2, hereditary bullous epidermolysis blisters occur in the hands, feet and other parts susceptible to trauma and friction, the contents of the bullae clarification, often family history.
2, neonatal exfoliative dermatitis often occurs in infants 1 to 5 weeks after birth, rash is diffuse flushing, loose bullae, rapid expansion, Nikolsky sign positive, rapid development of the disease, the epidermis is very easy to peel off a scalded appearance, the whole body The symptoms are critical and the mortality rate is high.
