Impetigo Essay

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Impetigo can occur in the bullous and nonbullous forms. Winn et al. (2006) stated it is a highly contagious bacterial infection of the superficial layers of the epidermis. Impetigo is caused by S.aureus in 80-90% of cases and in 10-20% of cases by S.pyogenes (p. 634). Nonbullous impetigo is caused by a host response to the bacterial infection, whereas a staphylococcal toxin causes bullous impetigo (Cole and Gazewood, 2007, p. 859). Nonbullous impetigo is more common and accounts for approximately 70% of reported impetigo diagnoses as described by (Cole and Gazewood, 2007, p. 859). In the same article Cole and Gazewood (2007) go on to describe the pathophysiology of nonbullous impetigo which starts as a single papule or red macule that rapidly turns into a vesicle. The vesicle breaks easily and forms an erosion of skin, soon after the liquid matter dries and forms a characteristic honey-colored crust that may be pus-like (p 859-860). Impetigo seems to be overwhelmingly spread by autoinoculation and tends to affect areas subject to environmental trauma, such as the extremities or the face as seen in the case of the patient described above (Cole and Gazewood, 2007, p. 859-860). In 2003, Brown, Shriner, Schwartz, and Janniger, stated, patients can easily auto inoculate themselves and pass the infection to others after excoriating an infected site. This allows a rapid distribution of infection, especially in places that have a high population of children such as schools and daycare. Children normally are normally infected through contact with other children, but fomites are another infection source as well. When adults are infected, they usually develop impetigo from contact with children or adults but can also contract an infection...

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...ve or systemic disease (Cole and Gazewood, 2007, p. 862). Scarring is unusual in most cases, but hyperpigmentation or hypopigmentation sometimes occur post infection. The prognosis for impetigo is a positive one. Most patients’ condition resolves in 2 weeks (Cole and Gazewood, 2007, p. 861). If complications do occur, acute post streptococcal glomerulonephritis is a very important one. It affects up to 5% of patients with nonboullous (Brown, Shriner, Schwartz, and Janniger, 2007, p. 252).
Better infection control practices and hand washing techniques utilized by the general population help to reduce the incidences of easily avoidable conditions, such as impetigo caused by staphylococcal and streptococcal infections. It may be beneficial for public health departments to recommend teachers to teach students on how to properly wash hands and clean high contact fomites.

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