infectious impetigo
Introduction
Introduction to infectious impetigo Infectious impetigo (Lmpetigo Contagiosa), also known as impetigo, infectious purulent rash, commonly known as yellow water sores. It is the most common purulent skin disease caused by pyogenic bacteria. It is mainly characterized by superficial pustules and purulent sputum. It is infected and spreads rapidly. It occurs mostly in summer and autumn and exposed parts, and is easy to be popular among children. . Infectious impetigo is prevalent in summer and autumn, most of which occurs in children. It is highly contagious. It is easily transmitted to each other in the family. It is more common in exposed parts. Due to different infections, clinical manifestations are different. Staphylococcus aureus Infected, mainly manifested as bullous impetigo, initially scattered red red papules or blisters, after the blister rapidly expands and increases, until the broad bean is larger or larger, the blister liquid begins to clear and then becomes turbid and becomes pus forming pus The blister is surrounded by redness, and sometimes the blister fluid on the abscess is clear, and the lower part is characterized by a turbid yellow pus deposited on the bottom of the blister and forming a half-moon shape, which is characteristic of the disease. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: contact spread Complications: erysipelas acute nephritis sepsis
Cause
Causes of infectious impetigo
Mainly coagulase-positive Staphylococcus aureus infection, mostly II group 71 strain, followed by type B hemolytic streptococcus, can also be mixed infection of two bacteria, very few other bacteria such as Staphylococcus epidermidis, Bacillus subtilis, etc. Caused.
Most of the patients are children and babies. Because of the anatomical and physiological weakness of the skin, such as the delicate skin, poor local resistance, easy to suffer minor trauma, skin is easy to stain and other factors, so the pyogenic bacteria are easy to infect, especially the newborn skin is thin and tender, secreted The function is not fully developed, the immunity is low (IgG level is lower than normal), the nerve function is not perfect, and it is easy to spread the whole body after infection, which causes the epidemic in the group. Adults suffer from certain diseases that reduce the body's resistance. When the body is weak or When the pruritic skin disease causes a certain part of the skin to reduce the resistance, and various stimuli, skin trauma, etc., the treatment of pyogenic bacteria causes the machine to be easily infected.
In families or nurseries, children are easily infected by close contact with each other, and can also be indirectly transmitted through contaminated towels, daily necessities, toys, clothes, etc.
Prevention
Infectious impetigo prevention
1. Pay attention to personal hygiene, take a bath and change clothes.
2. Have lice or itchy skin disease, should avoid scratching and timely treatment.
Complication
Infectious impetigo complication Complications erysipelas acute nephritis sepsis
A small number of patients with nasal cavity, oral and tongue mucosa can also be affected, severe cases may be associated with lymphadenitis, rickets, erysipelas or lymphangitis; may have fever, chills and other systemic symptoms, can also induce acute nephritis, very few infirm Children or neonatal patients can cause sepsis leading to death.
Symptom
Infectious impetigo symptoms Common symptoms Pustular itching edema pimples chills sepsis red halo bulls (with purulent liquid) erysipelas
Infectious impetigo is prevalent in summer and autumn, most of which occurs in children. It is highly contagious. It is easily transmitted to each other in the family. It is more common in exposed parts. Due to different infections, clinical manifestations are different. Staphylococcus aureus Infected, mainly manifested as bullous impetigo, initially scattered red red papules or blisters, after the blister rapidly expands and increases, until the broad bean is larger or larger, the blister liquid begins to clear and then becomes turbid and becomes pus forming pus The blister is surrounded by redness, sometimes the blister on the abscess is clear, and the lower part is formed by the turbid yellow pus deposited on the bottom of the blister and is in the shape of a half moon. It forms the characteristics of the disease. The wall is very thin, easy to break, and formed after breaking. The smashed surface forms a yellow purulent after drying, and sometimes the pus falls to the surrounding area, forming new pustules around the original lesion, and some are arranged in a ring or chain shape, called ring-shaped impetigo, which is good. On the exposed parts of the face, limbs, etc., consciously itching, generally no systemic symptoms.
The main manifestation of hemolytic streptococcus or mixed infection with Staphylococcus aureus is purulent impetigo, which occurs in exposed areas such as face, mouth, lips, nostrils, ears and extremities, and appears on the basis of erythema. The thin blisters then rapidly develop into pustules. There is a red blush around the pustules. After the pustules break, the pus is dry, forming a yellowish thick sputum. There are new rashes around, consciously itching, often broadcast by scratching. Dispersed to other parts of the body, a small number of patients nasal, oral and tongue mucosa can also be affected, severe cases may be associated with lymphadenitis, rickets, erysipelas or lymphangitis; may have fever, chills and other systemic symptoms, can also induce acute Nephritis, a very small number of frail children or neonatal patients can cause sepsis leading to death.
Examine
Infectious pustulosis
The total number of white blood cells and neutrophils can be increased in the laboratory. Staphylococcus aureus or streptococci can be isolated and cultured in the pus, and the bacteria can be identified if necessary.
Diagnosis
Diagnosis and diagnosis of infectious impetigo
diagnosis
According to the clinical characteristics of the damage, the season of the disease, age, location, the basic damage is pustules, there is redness around the pustules, the blister fluid is clear and turbid, no scars are left after the infection, the infection is strong, and the total number of white blood cells and neutrality are checked in the laboratory. Granulocytes can be increased, and the culture of pus bacteria is characterized by Staphylococcus aureus and Streptococcus, which is generally not difficult to diagnose.
Its pathological changes, pustules are located under the stratum corneum and between the granules, fibrin and a large number of neutrophils in the bleb, in the pustules, especially in the edge of the easy to find pyogenic cocci, significant intercellular edema of the epidermis (sponge formation And a large number of neutrophils, edema between dermal tissues, vasodilation and neutrophil and lymphocyte infiltration.
Differential diagnosis
Sometimes it is identified with the following diseases:
1. Deep pustulosis: deep pustulosis is ulcerated after ulceration, and there are shallow scars after the healing, more in the calf, adult hair.
2. Pemphigus: pemphigus is mainly vesicles, pustules are secondary infections, Nissl's sign is positive, mainly occurs in adults, pathological examination can be distinguished if necessary.
3. Eczema infection: Eczema infection has a history of eczema, erythema, papules and other polymorphic lesions on the skin, redness and inflammation, pustules and purulent sputum secondary damage.
4. Varicella: more common in winter and spring, before and during the onset of the disease often accompanied by fever, headache and other systemic symptoms, rash is mainly small blisters, multi-central distribution, at the same time visible erythema, papules and scars and other damage, Oral mucosa is often damaged.
5. Papular urticaria: characterized by the appearance of papules or blisters on the erythema-like erythema, such as on the trunk and limbs, appear in batches, repeated attacks, itching.
6. Neonatal impetigo: Neonatal impetigo occurs in newborns, with large pustules and severe systemic symptoms.
