Bacterial Skin Infections

Impetigo is a superficial bacterial infection of the skin.

The most common bacteria causing impetigo is Staphylococcus aureus, or “Staph aureus”. Less commonly, it can be caused by another bacteria, Streptococcus.

Impetigo is common in young children but can also affect people of other ages, especially those with skin that is damaged by cuts, insect bites, or eczema.

The bacteria can spread from by skin-to-skin contact or by touching contaminated surfaces such as towels and clothes.

Erysipelas and cellulitis are bacterial infections affecting deeper layers of skin. The most common bacteria causing erysipelas or cellulitis is Streptococcus, but other bacteria may be involved, including Staphylococcus aureus.

Compared to impetigo, erysipelas and cellulitis are not as contagious.

Erysipelas or cellulitis usually occurs through breaks in the skin e.g. cuts, insect bites or eczema.

A boil or abscess is a bacterial infection of the deeper part of the hair follicle within the skin. It is most often caused by Staphylococcus aureus.

Boils more commonly affect older children or teenagers.

Impetigo causes the affected skin to be red, itchy, and sometimes painful. Children are usually otherwise generally well, and most do not have a fever.

Impetigo can occur anywhere on the skin but most commonly affects the face, especially around the nose and mouth, and on the limbs.

It begins as small pus-filled blisters that break easily to become patches with golden yellow crusts and surrounding scales.

When treated appropriately, impetigo heals over a few days without leaving scars, although there may be temporary redness and darker pigmentation that may take weeks or months to resolve.

Erysipelas or cellulitis presents with pain, swelling, warmth, redness and sometimes blistering over the affected skin, usually over the arms or legs.

There may be fever, shivers, and general discomfort. The lymph glands nearest the infection may be swollen and painful.

In severe cases, complications can occur, like blood infection (sepsis), deeper infections to muscle, bone and joints, and meningitis (brain infection).

Rarely, kidney damage (glomerulonephritis) can occur with streptococcal infection. This can occur up to three weeks after the skin infection, and presents with cloudy or blood tinged urine, increased facial puffiness and swelling on the legs. See the doctor immediately if this occurs.

Boils begin as a small, itchy, and sometimes painful bump that develops into a bigger red lump under the skin surface. Occasionally, pus may be released from the boil. Fever and body-aches may be present.

Boils can occur anywhere on the body but is more common over sites with more hair.

The following measures will be helpful to reduce the spread of skin infections to other contacts:

Impetigo is diagnosed clinically. A skin swab from the affected area may be performed to grow the bacteria. If recurrent, a swab from your child’s nose to test for the presence of “Staph aureus” may be indicated.

Cellulitis and erysipelas are diagnosed by the typical appearance and symptoms. A skin swab may be done to identify the bacteria if there is broken skin. Blood tests may be required to monitor for complications e.g. blood infection.

Boils / abscesses are diagnosed by the typical appearance and symptoms. A skin swab may be done to identify the bacteria if pus is present. Blood tests may be required to monitor for complications e.g. blood infection.

Treatment depends on the severity and extent of the infection and include:

If the infection recurs, and if Staph aureus is found in the nose swab, the doctor may prescribe topical antibiotics to be applied into the nose, and anti-bacterial soap. It is important to follow the instructions given by the doctor.

ERYSIPELAS / CELLULITIS:

Treatment depends upon the severity of the infection.

For milder infections, a course of oral antibiotics for one to two weeks may be prescribed. It is important that the course of antibiotics is completed.

If the infection is not improving with oral medications, or if the infection is more severe, hospital admission for antibiotic injections may be required for a few days. These injections are given directly into the vein (intravenous or IV) through a plastic tube (cannula).

Other treatment measures that may be required include:

BOILS / ABSCESS:

Treatment depends upon the severity of the infection.

For milder infections, a course of oral antibiotics for one to two weeks may be prescribed. It is important that the course of antibiotics is completed.

If the infection is not improving with oral medications, or if pus is expressed from the boil, a minor operation to “open up” the boil may be performed by the doctor (incision and drainage). After the minor operation, the wound is left open and daily dressing is required until the wound heals up in one to two weeks.

For more severe cases, your child may be admitted to the hospital for a few days for antibiotic injections to be administered. These injections are given directly into the vein (intravenous or IV) through a plastic tube (cannula).

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