Impetigo: Etiology (Pediatric Nursing)

00:00 Now let's cover impetigo. Impetigo is a bacterial infection involving the superficial skin.

00:08 Classically, we see yellowish crusted lesions. This is either caused by Staph aureus or Streptococcus pyogenes and we can prevent this by handwashing and we treat it with antibiotics. So, there are 2 types. There's the non-bullous and the bullous forms. First, the non-bullous. These are superficial vesicles and pustules covered with honey-colored crust.

00:31 This is in contrast to the bullous, which is clusters and vesicles that are going to enlarge and form very large blisters called bullae and these blisters are going to burst and then cause an open wound then these will form honey-colored crust. So, these are caused by 2 bacteria.

00:46 Staph aureus, this is the most common that we see with bullous and nun-bullous forms. Then we have Streptococcus pyogenes and we see this with the nun-bullous form. About 70% of patients with impetigo have nun-bullous impetigo and about 30% have the bullous form. So this is caused by a breakdown in the skin's barrier and the resultant secondary bacterial infection. The skin breakdown can be from either a primary herpetic ulcer like herpes simplex virus or VZV which is shingles. So, remember the patient may be a candidate for antiviral therapy when they present and this should be considered in a patient who presents early in their viral course. We commonly see impetigo after a patient has had a cold sore and these lesions are typically found around the lips and around the nostrils and these are common sites for herpetic eruptions. This is very common in the pediatric population. Patients with eczema also get a break in their skin integrity and these bacteria can enter. So, risk factors; young children ages 2 through 5 and children who attend daycare because they're sharing toys and they usually play physically with each other and this is contagious, patients who are immunocompromised and patients who live in a warm climate. So, this is transmitted with direct contact with the lesions. The incubation is different based on the bacteria and Strep is about 1-3 days after exposure and if it's caused by Staph it takes about 4-10 days.