The topic is impetigo. Impetigo is a superficial skin infection, could be caused by either
strep or staph. So now, there are a couple of things that I want to make sure that
we go through or that we are clear about in micro. You have cellulitis, severe syphilis,
and then you have impetigo. Make sure that you’re clear about those 3 presentations
before we move on. All 3 could be caused by strep. Cellulitis will be a little bit deeper.
Syphilis would be extremely rapid caused by most likely strep A, fiery red, we call that
St. Vincent’s fire, and here we have impetigo, either strep or staph. Demographics,
often in children, and usually on the central phase. And if you take a look at the picture
here, you’ll notice that it’s honey-crusted lesions, extremely distinctive and characteristic
for impetigo, honey-crusted lesions that we’re seeing here specifically in the perioral
area. Now, if in fact, it is going to be a strep A infection and approximately let’s say
4 weeks later, the patient, the child, starts having let’s say blood that appears in the
urine. This is the discussion that we’ve had earlier where if this impetigo is in fact being
caused by group A streptococci or pyogenes that approximately 4 weeks later we have
now developed post-streptococcal glomerulonephritis. So, are we clear? Diagnosis,
clinical appearance, no doubt culture obviously and cannot be diagnosed with serologic
test for strep. Management, oral antibiotics and you have topical mupirocin ointment.
Topic here is staph-scalded skin or scalded skin syndrome. We have exfoliation caused
by toxin produced by Staph aureus infection. So, our topic is staphylococcal scalded
skin syndrome. We have a toxin of the Staph aureus which is going to cause an issue
and whom, infants, and unfortunately most common with infants and those with renal
failure, scalded skin syndrome. With staph, the management with IV antibiotics either
vanco or Nafcillin and supportive care.