Impetigo
Impetigo is a superficial, highly contagious bacterial skin infection common in children, treated per the IDSA 2014 Skin and Soft Tissue Infection guideline.
Symptoms
Honey-colored crusted sores, usually around the nose and mouth, that start as small blisters or red bumps and spread quickly with scratching.
Causes and risk
Staphylococcus aureus and Streptococcus pyogenes bacteria, spread by skin-to-skin contact; warm weather, close contact settings like schools and daycares, and minor skin breaks (insect bites, eczema) all raise risk.
How it is evaluated
Diagnosis is usually clinical based on the characteristic honey-colored crusting; a culture is sometimes taken if MRSA is suspected or treatment fails.
Treatment
Topical mupirocin twice daily for 5 days treats limited disease; oral antibiotics (dicloxacillin, cephalexin, or an MRSA-active agent when indicated) are used for numerous lesions, outbreaks, or when topical treatment fails, per the IDSA guideline.
When to seek care
Fever, spreading redness and swelling, or blood in the urine (a rare sign of post-streptococcal kidney inflammation) after impetigo warrant prompt medical evaluation.