Bullous Impetigo - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Impetigo is a highly infectious infection of the surface layers of the epidermis that is typically brought on by gram-positive bacteria. It usually appears as yellow-crusted erythematous plaques, which can hurt or itch. The lesions spread quickly and are very contagious. A common illness among kids living in hot, humid areas is impetigo. Bullous or nonbullous infections are both possible. Though it can affect any other part of the body with an abrasion, laceration, bug bite, or other trauma, the illness usually affects the face. Usually, the symptoms and clinical signs alone are used to diagnose. In addition to symptomatic care, the treatment includes oral and topical antibiotics.

What Is Bullous Impetigo?

Bacteria such as Staphylococcus aureus and Streptococcus pyogenes cause infection of the outer layers of the skin (epidermis). This infection is characterized by large bullae-like blisters on the body filled with clear fluid, which turns cloudy later. This infection is called bullous impetigo. The most commonly affected body sites are the legs, hands, arms, and face. Places where the skin forms folds are also widely affected, like underarms, below the breasts, or between the buttocks. However, any site of the body can be involved.

The infection can occur in healthy skin or broken (rash around a baby's mouth, cuts, or insect bites) skin. Depending on this, bullous impetigo is classified as primary impetigo (when infection occurs on healthy skin) and secondary impetigo (when infection occurs on already damaged skin). Bullous impetigo is common in developing countries and is most common during the summer.

What Causes Bullous Impetigo?

• Bullous impetigo is a common, contagious (can spread from person to person or from one place of the body to another) bacterial infection.

• The bacteria that cause bullous impetigo are Staphylococcus aureus or Streptococcus pyogenes.

• The bacteria can enter the body through any cuts or openings in the skin.

• A person might get infected if they come into direct contact with the lesions of another person or can also spread if they come into contact with the towels or items used by the infected person.

• Some people have infective bacteria inside their nostrils, which might later spread to the body and cause bullous impetigo blisters.

What Are the Signs and Symptoms of Bullous Impetigo?

• Bullous impetigo often starts as a red rash on the skin. It can be painless or, often, itchy and uncomfortable. The rashes then develop into large blisters about five millimeters in diameter, containing clear fluid that later oozes out, leaving a scaly rim of scar tissue called a collarette. The newborn lip blister often involves adjacent areas of the skin.

• In rare instances, the red spots or rashes may develop directly into a yellow spot without any blister formation.

• The scars fade eventually.

• The person might develop a fever or diarrhea.

• Swelling of the nearby glands might also occur.

• When the bacteria's toxins spread to other body parts, the condition is called Staphylococcal scalded skin syndrome (SSSS).

• When the bacteria moves from affecting the skin to the bloodstream, it can cause more serious medical complications. This situation is called toxic shock syndrome.

• Reach out for medical emergency care if experience the following rapid symptoms,

• High body temperatures (fever).

• Low blood pressure (hypotension).

• Rapid heart rate.

• Confusion or inability to concentrate.

• Rapid breathing.

How to Diagnose Bullous Impetigo?

When the above-mentioned symptoms are experienced, visit a doctor to make an appropriate diagnosis. For example, the doctor might diagnose bullous impetigo just by seeing it. Or, if the condition does not resolve in a few weeks, the doctor might ask for a culture test to confirm the bacteria and prescribe medicines against the infection.

How to Treat Bullous Impetigo?

Antibiotics are the main ingredient that helps with the cure of bullous impetigo.

• If the newborn lip blister is mild without any systemic complications, the doctor might prescribe a topical antibiotic cream such as Muciprocin cream or ointment such as impetigo treatment cream.

• If the patient experiences rapid progression of the blisters or if they have any systemic complications like fever or diarrhea, then the doctor might prescribe oral antibiotics like

• Augmentin (Amoxicillin and Potassium Clavulanate).

• Some Cephalosporins.

• Clindamycin.

• Oral antibiotics help reduce systemic complications and the effects and progression of bacteria. However, intra-oral antibiotics have certain complications, like nausea, that might not occur with topical antibiotics.

• The infection usually cures in about seven to ten days. However, in some cases, it might take longer to heal.

What Are the Common Risk Factors for Bullous Impetigo?

Following are some of the common risk factors for bullous impetigo;

• Warm, humid conditions.

• Uncontrolled diabetes.

• Immunocompromised individuals (HIV (human immunodeficiency virus) infected individuals and people under immunosuppressants).

• Skin conditions like psoriasis, dermatitis, and eczema.

• Burns and sunburns.

• Open cuts or rash around baby’s mouth.

• Already present skin problems like scabies, lice, herpes simplex, and chickenpox.

• Sports activity that involves contact with other people's sweat.

• Improper personal hygiene.

• Sharing clothes.

How Can Bullous Impetigo Be Prevented?

Bullous impetigo lesions are highly contagious, and they can spread from one person to another quickly. This is seen commonly among children and is known to spread from one child to another in school. Hence, this disease is also known as a school disease.

Following are a few steps to prevent bullous impetigo:

• Clip and trim the nails to avoid accumulating dirt, which might have bacteria.

• Wash hands with soap frequently.

• Bathe regularly and adequately. Ensure to clean the body areas with skin folds, such as the underarms, below breasts, etc.

• Cover any open wounds or cuts to prevent infection.

• Never scratch or cut any lesion, as they could spread the infection.

• Change the bed linen often, especially when a person affected by bullous impetigo sleeps on it.

• Clean the surfaces of the doorknobs and cellular phones with disinfectants touched by the infected individuals.

• Do not share personal items like face towels or razors with someone affected by bullous impetigo.

Conclusion:

Bullous impetigo is very common and is highly contagious if not appropriately maintained. Therefore, ensure good personal hygiene and prevent direct contact with the person affected by impetigo until they are entirely cured to avoid spreading the infection. Then, follow the above-mentioned preventive measures to save themselves and their loved ones from being infected. If presented with the symptoms mentioned above, visit the general physician to prevent complications.