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Impetigo, Emergency Medicine

Irving Jacoby Reviewed 06/2017
 


Basics

Description

  • Impetigo is a common infection of the skin

  • Primary infection:

    • Infection of minor breaks in the skin

  • Secondary infection:

    • Infection of previously existing skin lesions, known as “impetigi...

Diagnosis

Signs and Symptoms

  • Classic (nonbullous) impetigo:

    • Begins as a single 2–4 mm erythematous macule or papule that may evolve into a vesicle or pustule, on a red base

    • Rupture of the vesicle, usuall...

Treatment

Pre-Hospital

  • Apply dressings to cover for transport

  • Gloves must be worn, as agents can be transmitted person to person

  • Cautions:

    • Maintain universal precautions

    • Siblings of affected children in sa...

Follow-Up

Disposition

Admission Criteria

  • Admission for impetigo alone is rarely necessary

  • Patients with disease that is widespread, especially widespread bullae, or with larger areas of denuded skin, and...

Pearls and Pitfalls

  • Treat with systemic antibiotics in the presence of bullous impetigo or if lymphadenopathy is present

  • Increasing antibiotic resistance continues to limit ability to use historic stan...

Additional Reading

  • Darmstadt  GL, Osendarp  SJ, Ahmed  S, et al. Effect of antenatal zinc supplementation on impetigo in infants in Bangladesh. Pediatr Infect Dis J.  2012;31:407–409.

  • Koning  S, v...

Codes

ICD9

  • 684 Impetigo

  • 694.3 Impetigo herpetiformis

  • 704.8 Other specified diseases of hair and hair follicles

ICD10

  • L01.00 Impetigo, unspecified

  • L01.01 Non-bullous impetigo

  • L01.03 Bullous impetigo

  • L01.09 Oth...

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