Materiały źródłowe

• #1

  https://step2.medbullets.com/evidence/25250996

  Impetigo is the most common bacterial skin infection in children two to five years of age. There are two principal types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas. Both types usually resolve within two to three weeks without scarring, and complications are rare, with the most serious being poststreptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical. Amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides are options, but penicillin is not. Natural therapies such as tea tree oil; olive, garlic, and coconut oils; and Manuka honey have been anecdotally successful, but lack sufficient evidence to recommend or dismiss them as treatment options. Treatments under development include minocycline foam and Ozenoxacin, a topical quinolone. Topical disinfectants are inferior to antibiotics and should not be used. Empiric treatment considerations have changed with the increasing prevalence of antibiotic-resistant bacteria, with methicillin-resistant S. aureus, macrolide-resistant streptococcus, and mupirocin-resistant streptococcus all documented. Fusidic acid, mupirocin, and retapamulin cover methicillin-susceptible S. aureus and streptococcal infections. Clindamycin proves helpful in suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole covers methicillin-resistant S. aureus infection, but is inadequate for streptococcal infection.

• #2 Impetigo: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html

  Impetigo is the most common bacterial skin infection in children two to five years of age. […] The diagnosis of nonbullous and bullous impetigo is nearly always clinical. […] In patients in whom first-line therapy fails, culture of the pus or bullous fluid, not the intact skin, may be helpful for pathogen identification and antimicrobial susceptibilities. […] Although serologic testing for streptococcal antibodies is helpful in the diagnosis of acute poststreptococcal glomerulonephritis, it does not aid in the diagnosis of impetigo. […] Impetigo is usually a self-limited condition, and although rare, complications can occur. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.

• #3 Impetigo – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430974/

  Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. […] Diagnosis is typically based on the symptoms and clinical manifestations alone. […] History and physical exam are essential to the diagnosis of impetigo. Bacterial cultures can be used for confirmation of diagnosis and should be obtained if methicillin-resistant staph aureus (MRSA) is suspected or if an impetigo outbreak is present. […] The anti-streptolysin O (ASO) response is weak from impetigo alone. Therefore, serologic testing for streptococcal antibodies is not indicated for the diagnosis of impetigo. […] Topical antibiotics alone or in conjunction with systemic antibiotics are used to treat impetigo. Antibiotic coverage should cover both S aureus and S pyogenes (i.e. GABHS).

• #4 Clinical Guidance for Group A Streptococcal Impetigo | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/impetigo.html

  Impetigo is diagnosed by physical examination. […] Physical examination cannot reliably differentiate between streptococcal and staphylococcal non-bullous impetigo. […] Laboratory testing isn’t necessary nor routinely performed in clinical practice. However, Gram stain or culture of the exudate or pus from an impetigo lesion can identify the bacterial cause.

• #5 Impetigo – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/476

  Impetigo is a highly contagious and common bacterial infection of the skin that typically occurs in children; a key consideration for schools and playgroups. […] Diagnosis is usually clinical; bacterial skin cultures are reserved for extensive disease or where there is risk of spread of infection. […] Key diagnostic factors include vesicles/bullae and crusting. […] Other diagnostic factors include erythema, pruritus, pain, mucopurulent exudate, lymphadenopathy, and fever. […] 1st tests to order include clinical diagnosis. […] Tests to consider include bacterial skin culture.

• #6 About Impetigo | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/about/impetigo.html

  Healthcare providers typically diagnose impetigo by looking at the sores during a physical examination. Lab tests are not needed. […] People with impetigo can return to work, school, or daycare if they have started antibiotic treatment. They should also cover all sores on exposed skin.

• #7

  https://step2.medbullets.com/evidence/25250996

  Impetigo is the most common bacterial skin infection in children two to five years of age. There are two principal types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas. Both types usually resolve within two to three weeks without scarring, and complications are rare, with the most serious being poststreptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical. Amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides are options, but penicillin is not. Natural therapies such as tea tree oil; olive, garlic, and coconut oils; and Manuka honey have been anecdotally successful, but lack sufficient evidence to recommend or dismiss them as treatment options. Treatments under development include minocycline foam and Ozenoxacin, a topical quinolone. Topical disinfectants are inferior to antibiotics and should not be used. Empiric treatment considerations have changed with the increasing prevalence of antibiotic-resistant bacteria, with methicillin-resistant S. aureus, macrolide-resistant streptococcus, and mupirocin-resistant streptococcus all documented. Fusidic acid, mupirocin, and retapamulin cover methicillin-susceptible S. aureus and streptococcal infections. Clindamycin proves helpful in suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole covers methicillin-resistant S. aureus infection, but is inadequate for streptococcal infection.

• #8 Impetigo – UpToDate

  https://www.uptodate.com/contents/impetigo

  Variants of impetigo include nonbullous impetigo, bullous impetigo, and ecthyma. Systemic symptoms are usually absent. Regional lymphadenitis may occur. […] Nonbullous impetigo is the most common form of impetigo. Lesions begin as papules that progress to vesicles surrounded by erythema. Subsequently they become pustules that enlarge and rapidly break down to form thick, adherent crusts with a characteristic golden appearance; this evolution usually occurs over approximately one week. […] Bullous impetigo is a form of impetigo seen primarily in young children in which the vesicles enlarge to form flaccid bullae with clear yellow fluid, which later becomes darker and more turbid; ruptured bullae leave a thin brown crust.

• #9 Impetigo – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/476

  Impetigo is a highly contagious and common bacterial infection of the skin that typically occurs in children; a key consideration for schools and playgroups. […] Diagnosis is usually clinical; bacterial skin cultures are reserved for extensive disease or where there is risk of spread of infection. […] Key diagnostic factors include vesicles/bullae and crusting. […] Other diagnostic factors include erythema, pruritus, pain, mucopurulent exudate, lymphadenopathy, and fever. […] 1st tests to order include clinical diagnosis. […] Tests to consider include bacterial skin culture.

• #10 Impetigo – UpToDate

  https://www.uptodate.com/contents/impetigo

  Variants of impetigo include nonbullous impetigo, bullous impetigo, and ecthyma. Systemic symptoms are usually absent. Regional lymphadenitis may occur. […] Nonbullous impetigo is the most common form of impetigo. Lesions begin as papules that progress to vesicles surrounded by erythema. Subsequently they become pustules that enlarge and rapidly break down to form thick, adherent crusts with a characteristic golden appearance; this evolution usually occurs over approximately one week. […] Bullous impetigo is a form of impetigo seen primarily in young children in which the vesicles enlarge to form flaccid bullae with clear yellow fluid, which later becomes darker and more turbid; ruptured bullae leave a thin brown crust.

• #11

  https://step2.medbullets.com/evidence/25250996

  Impetigo is the most common bacterial skin infection in children two to five years of age. There are two principal types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas. Both types usually resolve within two to three weeks without scarring, and complications are rare, with the most serious being poststreptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical. Amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides are options, but penicillin is not. Natural therapies such as tea tree oil; olive, garlic, and coconut oils; and Manuka honey have been anecdotally successful, but lack sufficient evidence to recommend or dismiss them as treatment options. Treatments under development include minocycline foam and Ozenoxacin, a topical quinolone. Topical disinfectants are inferior to antibiotics and should not be used. Empiric treatment considerations have changed with the increasing prevalence of antibiotic-resistant bacteria, with methicillin-resistant S. aureus, macrolide-resistant streptococcus, and mupirocin-resistant streptococcus all documented. Fusidic acid, mupirocin, and retapamulin cover methicillin-susceptible S. aureus and streptococcal infections. Clindamycin proves helpful in suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole covers methicillin-resistant S. aureus infection, but is inadequate for streptococcal infection.

• #12 Impetigo – UpToDate

  https://www.uptodate.com/contents/impetigo

  Variants of impetigo include nonbullous impetigo, bullous impetigo, and ecthyma. Systemic symptoms are usually absent. Regional lymphadenitis may occur. […] Nonbullous impetigo is the most common form of impetigo. Lesions begin as papules that progress to vesicles surrounded by erythema. Subsequently they become pustules that enlarge and rapidly break down to form thick, adherent crusts with a characteristic golden appearance; this evolution usually occurs over approximately one week. […] Bullous impetigo is a form of impetigo seen primarily in young children in which the vesicles enlarge to form flaccid bullae with clear yellow fluid, which later becomes darker and more turbid; ruptured bullae leave a thin brown crust.

• #13

  https://step2.medbullets.com/evidence/25250996

  Impetigo is the most common bacterial skin infection in children two to five years of age. There are two principal types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas. Both types usually resolve within two to three weeks without scarring, and complications are rare, with the most serious being poststreptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical. Amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides are options, but penicillin is not. Natural therapies such as tea tree oil; olive, garlic, and coconut oils; and Manuka honey have been anecdotally successful, but lack sufficient evidence to recommend or dismiss them as treatment options. Treatments under development include minocycline foam and Ozenoxacin, a topical quinolone. Topical disinfectants are inferior to antibiotics and should not be used. Empiric treatment considerations have changed with the increasing prevalence of antibiotic-resistant bacteria, with methicillin-resistant S. aureus, macrolide-resistant streptococcus, and mupirocin-resistant streptococcus all documented. Fusidic acid, mupirocin, and retapamulin cover methicillin-susceptible S. aureus and streptococcal infections. Clindamycin proves helpful in suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole covers methicillin-resistant S. aureus infection, but is inadequate for streptococcal infection.

• #14 Impetigo – UpToDate

  https://www.uptodate.com/contents/impetigo

  Variants of impetigo include nonbullous impetigo, bullous impetigo, and ecthyma. Systemic symptoms are usually absent. Regional lymphadenitis may occur. […] Nonbullous impetigo is the most common form of impetigo. Lesions begin as papules that progress to vesicles surrounded by erythema. Subsequently they become pustules that enlarge and rapidly break down to form thick, adherent crusts with a characteristic golden appearance; this evolution usually occurs over approximately one week. […] Bullous impetigo is a form of impetigo seen primarily in young children in which the vesicles enlarge to form flaccid bullae with clear yellow fluid, which later becomes darker and more turbid; ruptured bullae leave a thin brown crust.

• #15 Impetigo – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/impetigo/diagnosis-treatment/drc-20352358

  To diagnose impetigo, your doctor might look for sores on your face or body. Lab tests generally aren’t needed. […] If the sores don’t clear, even with antibiotic treatment, your doctor might take a sample of the liquid produced by a sore and test it to see what types of antibiotics would work best on it. Some types of the bacteria that cause impetigo have become resistant to certain antibiotics.

• #16 Impetigo – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430974/

  Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. […] Diagnosis is typically based on the symptoms and clinical manifestations alone. […] History and physical exam are essential to the diagnosis of impetigo. Bacterial cultures can be used for confirmation of diagnosis and should be obtained if methicillin-resistant staph aureus (MRSA) is suspected or if an impetigo outbreak is present. […] The anti-streptolysin O (ASO) response is weak from impetigo alone. Therefore, serologic testing for streptococcal antibodies is not indicated for the diagnosis of impetigo. […] Topical antibiotics alone or in conjunction with systemic antibiotics are used to treat impetigo. Antibiotic coverage should cover both S aureus and S pyogenes (i.e. GABHS).

• #17 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  Diagnosis of impetigo is usually based solely on history and clinical appearance. Bacterial culture and sensitivity are recommended (1) to identify possible methicillin-resistant Staphylococcus aureus (MRSA), (2) if an outbreak of impetigo has occurred, or (3) if poststreptococcal glomerulonephritis is present. Evidence of previous streptococcal skin infection may be sought in individuals in whom acute poststreptococcal glomerulonephritis (APSGN) is suspected. […] In patients with nonbullous lesions, after cleansing the honey-colored crusted lesion and uplifting the scab, a bacterial culture of the fresh exudate underneath the scab may be obtained. In patients with bullous lesions, Gram stain and culture of the blister fluid is performed. On Gram stain, the presence of gram-positive cocci in chains indicates Streptococcus pyogenes; gram-positive cocci in clusters indicate S aureus. Culture and sensitivity results can help the physician choose appropriate antibiotic therapy.

• #18 Impetigo and Ecthyma – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/impetigo-and-ecthyma

  Impetigo is a superficial skin infection with crusting or bullae caused by streptococci, staphylococci, or both. […] Diagnosis is clinical. […] Diagnosis of impetigo and ecthyma is by characteristic appearance. […] Cultures of lesions are indicated only when the patient does not respond to empiric therapy. […] Patients with recurrent impetigo should have nasal culture. […] Persistent infections should be cultured to identify MRSA. […] For persistent impetigo, culture the lesion (to identify methicillin-resistant S. aureus [MRSA]) and the nose (to identify a potential nasal reservoir).

• #19 Impetigo: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html

  Impetigo is the most common bacterial skin infection in children two to five years of age. […] The diagnosis of nonbullous and bullous impetigo is nearly always clinical. […] In patients in whom first-line therapy fails, culture of the pus or bullous fluid, not the intact skin, may be helpful for pathogen identification and antimicrobial susceptibilities. […] Although serologic testing for streptococcal antibodies is helpful in the diagnosis of acute poststreptococcal glomerulonephritis, it does not aid in the diagnosis of impetigo. […] Impetigo is usually a self-limited condition, and although rare, complications can occur. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.

• #20 Impetigo: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/impetigo/?srsltid=AfmBOoptWY97iTQ1khgk2VIbMgz0iHM9iP7aNUYXTVZbI-i0mVEY7ADr

  Healthcare providers diagnose impetigo based on the physical examination and past medical history (DynaMed, 2018a; Nardi et al., 2021). […] Lab cultures are not routine, but may be drawn in the following circumstances: […] Treatment failure […] Possible methicillin-resistant staphylococcus aureus (MRSA) infection […] Community outbreak.

• #21 Impetigo | Doctor

  https://patient.info/doctor/impetigo-pro

  Diagnosing impetigo is usually purely clinical but a swab for culture and sensitivity may be useful if: […] The impetigo is extensive or severe. […] MRSA is suspected. […] The impetigo is recurrent or failing to respond to treatment.

• #22 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  Diagnosis of impetigo is usually based solely on history and clinical appearance. Bacterial culture and sensitivity are recommended (1) to identify possible methicillin-resistant Staphylococcus aureus (MRSA), (2) if an outbreak of impetigo has occurred, or (3) if poststreptococcal glomerulonephritis is present. Evidence of previous streptococcal skin infection may be sought in individuals in whom acute poststreptococcal glomerulonephritis (APSGN) is suspected. […] In patients with nonbullous lesions, after cleansing the honey-colored crusted lesion and uplifting the scab, a bacterial culture of the fresh exudate underneath the scab may be obtained. In patients with bullous lesions, Gram stain and culture of the blister fluid is performed. On Gram stain, the presence of gram-positive cocci in chains indicates Streptococcus pyogenes; gram-positive cocci in clusters indicate S aureus. Culture and sensitivity results can help the physician choose appropriate antibiotic therapy.

• #23 Impetigo: Types, Symptoms, Causes, Diagnosis, Treatment and More

  https://www.health.com/impetigo-overview-7494686

  A healthcare provider can diagnose impetigo by looking at the appearance of your sores during a physical exam. […] However, they may also choose to order a bacterial culture or a biopsy to confirm the diagnosis in some cases. […] Common diagnostic tests for impetigo include: […] Skin swab: A fluid sample from the blister or sore is collected and sent to the lab to identify the type of bacteria causing the infection. […] Nasal swab: In cases of recurrent or severe impetigo, a sample of fluids is taken from the nose and sent to the lab to determine if a resistant bacteria, such as MRSA, is causing the infection. […] Biopsy: A small sample of skin is taken from the area surrounding the infection and examined under a microscope. This test is rarely needed but can help diagnose impetigo in cases where the diagnosis is uncertain. […] In most cases, these tests are unnecessary for diagnosing impetigo; healthcare providers can typically use their clinical judgment to diagnose impetigo during a physical exam.

• #24 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  Documentation of a recent streptococcal skin infection in the differential diagnosis of APSGN is accomplished best by obtaining antideoxyribonuclease B (anti-DNase B) and antihyaluronidase (AH) titers. More than 92% of patients with impetigo-associated APSGN have elevated anti-DNase B titers. Patients with impetigo have a poor antistreptolysin O (ASO) serologic response; only 51% of patients with impetigo-associated APSGN develop an increased ASO titer. […] Urinalysis is necessary to evaluate for APSGN if the patient develops new-onset edema or hypertension. Hematuria, proteinuria, and cylindruria are indicators of renal involvement. […] A potassium hydroxide wet mount may be performed to exclude bullous dermatophyte infection. A Tzanck preparation or viral culture may be performed to exclude herpes simplex infection.

• #25 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  A bacterial culture of the nares may be obtained to determine whether a patient is an S aureus carrier. If the nares culture is negative and the patient has persistent recurrent episodes of impetigo, bacterial cultures should be obtained from the axillae, pharynx, and perineum. […] Obtain serum IgM levels in cases of recurrent impetigo in patients with negative S aureus carrier status and no predisposing factors such as a preexisting dermatosis. […] Biopsy may be appropriate in doubtful or refractory cases of impetigo. […] In bullous impetigo, few or no inflammatory cells are present within the bulla. A polymorphous infiltrate is present in the upper dermis. Acantholysis is noted in the granular layer. […] In nonbullous impetigo, a serum crust is present above the epidermis. Neutrophils are common within the crust. In addition, gram-positive cocci are seen. Epidermal spongiosis and a severe dermal infiltrate of neutrophils and lymphoid cells are seen.

• #26 Impetigo (school sores, skin infections): Images, Causes, and Symptoms — DermNet

  https://dermnetnz.org/topics/impetigo

  Impetigo is usually a clinical diagnosis based on the features described above. […] A skin swab for culture and sensitivity may be beneficial if the impetigo is recurrent, widespread or there is concern of MRSA infection. […] Nasal swabs should be carried out in recurrent infection as they can identify staphylococcal nasal carriage which requires specific management. […] Rarely a biopsy may be indicated if the diagnosis is unclear (in particular for bullous impetigo) or if it is refractory to treatment. […] Histological features are characteristic.

• #27 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  Documentation of a recent streptococcal skin infection in the differential diagnosis of APSGN is accomplished best by obtaining antideoxyribonuclease B (anti-DNase B) and antihyaluronidase (AH) titers. More than 92% of patients with impetigo-associated APSGN have elevated anti-DNase B titers. Patients with impetigo have a poor antistreptolysin O (ASO) serologic response; only 51% of patients with impetigo-associated APSGN develop an increased ASO titer. […] Urinalysis is necessary to evaluate for APSGN if the patient develops new-onset edema or hypertension. Hematuria, proteinuria, and cylindruria are indicators of renal involvement. […] A potassium hydroxide wet mount may be performed to exclude bullous dermatophyte infection. A Tzanck preparation or viral culture may be performed to exclude herpes simplex infection.

• #28 Impetigo: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html

  Impetigo is the most common bacterial skin infection in children two to five years of age. […] The diagnosis of nonbullous and bullous impetigo is nearly always clinical. […] In patients in whom first-line therapy fails, culture of the pus or bullous fluid, not the intact skin, may be helpful for pathogen identification and antimicrobial susceptibilities. […] Although serologic testing for streptococcal antibodies is helpful in the diagnosis of acute poststreptococcal glomerulonephritis, it does not aid in the diagnosis of impetigo. […] Impetigo is usually a self-limited condition, and although rare, complications can occur. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.

• #29 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  Documentation of a recent streptococcal skin infection in the differential diagnosis of APSGN is accomplished best by obtaining antideoxyribonuclease B (anti-DNase B) and antihyaluronidase (AH) titers. More than 92% of patients with impetigo-associated APSGN have elevated anti-DNase B titers. Patients with impetigo have a poor antistreptolysin O (ASO) serologic response; only 51% of patients with impetigo-associated APSGN develop an increased ASO titer. […] Urinalysis is necessary to evaluate for APSGN if the patient develops new-onset edema or hypertension. Hematuria, proteinuria, and cylindruria are indicators of renal involvement. […] A potassium hydroxide wet mount may be performed to exclude bullous dermatophyte infection. A Tzanck preparation or viral culture may be performed to exclude herpes simplex infection.

• #30 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  A bacterial culture of the nares may be obtained to determine whether a patient is an S aureus carrier. If the nares culture is negative and the patient has persistent recurrent episodes of impetigo, bacterial cultures should be obtained from the axillae, pharynx, and perineum. […] Obtain serum IgM levels in cases of recurrent impetigo in patients with negative S aureus carrier status and no predisposing factors such as a preexisting dermatosis. […] Biopsy may be appropriate in doubtful or refractory cases of impetigo. […] In bullous impetigo, few or no inflammatory cells are present within the bulla. A polymorphous infiltrate is present in the upper dermis. Acantholysis is noted in the granular layer. […] In nonbullous impetigo, a serum crust is present above the epidermis. Neutrophils are common within the crust. In addition, gram-positive cocci are seen. Epidermal spongiosis and a severe dermal infiltrate of neutrophils and lymphoid cells are seen.

• #31 Impetigo – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430974/

  Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. […] Diagnosis is typically based on the symptoms and clinical manifestations alone. […] History and physical exam are essential to the diagnosis of impetigo. Bacterial cultures can be used for confirmation of diagnosis and should be obtained if methicillin-resistant staph aureus (MRSA) is suspected or if an impetigo outbreak is present. […] The anti-streptolysin O (ASO) response is weak from impetigo alone. Therefore, serologic testing for streptococcal antibodies is not indicated for the diagnosis of impetigo. […] Topical antibiotics alone or in conjunction with systemic antibiotics are used to treat impetigo. Antibiotic coverage should cover both S aureus and S pyogenes (i.e. GABHS).

• #32 Impetigo (school sores, skin infections): Images, Causes, and Symptoms — DermNet

  https://dermnetnz.org/topics/impetigo

  Impetigo is usually a clinical diagnosis based on the features described above. […] A skin swab for culture and sensitivity may be beneficial if the impetigo is recurrent, widespread or there is concern of MRSA infection. […] Nasal swabs should be carried out in recurrent infection as they can identify staphylococcal nasal carriage which requires specific management. […] Rarely a biopsy may be indicated if the diagnosis is unclear (in particular for bullous impetigo) or if it is refractory to treatment. […] Histological features are characteristic.

• #33 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  A bacterial culture of the nares may be obtained to determine whether a patient is an S aureus carrier. If the nares culture is negative and the patient has persistent recurrent episodes of impetigo, bacterial cultures should be obtained from the axillae, pharynx, and perineum. […] Obtain serum IgM levels in cases of recurrent impetigo in patients with negative S aureus carrier status and no predisposing factors such as a preexisting dermatosis. […] Biopsy may be appropriate in doubtful or refractory cases of impetigo. […] In bullous impetigo, few or no inflammatory cells are present within the bulla. A polymorphous infiltrate is present in the upper dermis. Acantholysis is noted in the granular layer. […] In nonbullous impetigo, a serum crust is present above the epidermis. Neutrophils are common within the crust. In addition, gram-positive cocci are seen. Epidermal spongiosis and a severe dermal infiltrate of neutrophils and lymphoid cells are seen.

• #34 Impetigo Workup: Approach Considerations, Histologic Findings

  https://emedicine.medscape.com/article/965254-workup

  A bacterial culture of the nares may be obtained to determine whether a patient is an S aureus carrier. If the nares culture is negative and the patient has persistent recurrent episodes of impetigo, bacterial cultures should be obtained from the axillae, pharynx, and perineum. […] Obtain serum IgM levels in cases of recurrent impetigo in patients with negative S aureus carrier status and no predisposing factors such as a preexisting dermatosis. […] Biopsy may be appropriate in doubtful or refractory cases of impetigo. […] In bullous impetigo, few or no inflammatory cells are present within the bulla. A polymorphous infiltrate is present in the upper dermis. Acantholysis is noted in the granular layer. […] In nonbullous impetigo, a serum crust is present above the epidermis. Neutrophils are common within the crust. In addition, gram-positive cocci are seen. Epidermal spongiosis and a severe dermal infiltrate of neutrophils and lymphoid cells are seen.

• #35 Impetigo differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Impetigo_differential_diagnosis

  Impetigo must be differentiated from other diseases that cause pustules surrounded by erythematous skin, including chickenpox, herpes zoster, erythema multiforme, among others. […] Different rash-like conditions can be confused with impetigo and are thus included in the differential diagnosis. […] It commonly presents with pimple-like lesions surrounded by erythematous skin. Lesions are pustules, filled with pus, which then break down over 4-6 days and form a thick crust. It’s often associated with insect bites, cuts, and other forms of trauma to the skin.

• #36 Impetigo

  https://www.nhs.uk/conditions/impetigo/

  Impetigo can look similar to other skin conditions. Skin symptoms Possible cause Blisters on lips or around the mouth Cold sores Itchy, dry, cracked or sore skin Atopic eczema Itchy blisters Shingles, chickenpox […] A GP or pharmacist will check if your symptoms are caused by a more serious skin infection, like cellulitis. […] A GP can take a swab from your skin to check for the bacteria that causes impetigo. They may also take a swab from inside your nose.

• #37 Impetigo – Wikipedia

  https://en.wikipedia.org/wiki/Impetigo

  Impetigo is usually diagnosed based on its appearance. It generally appears as honey-colored scabs formed from dried sebum and is often found on the arms, legs, or face. […] If a visual diagnosis is unclear a culture may be done to test for resistant bacteria. […] Other conditions that can result in symptoms similar to the common form include contact dermatitis, herpes simplex virus, discoid lupus, and scabies. […] Other conditions that can result in symptoms similar to the blistering form include other bullous skin diseases, burns, and necrotizing fasciitis.

• #38 Impetigo – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/impetigo-3/

  Impetigo is usually a clinical diagnosis. Bacterial culture and sensitivity can be used to confirm the diagnosis and identify the causative pathogen. […] A bacterial culture of the nares can be performed to ascertain if the individual carries S aureus. […] The differential diagnosis includes candidiasis, cellulitis, herpes simplex, and burns of the skin. […] Impetigo occurs more commonly in children. Neonates are a particularly high-risk group. Impetigo occurs equally in males and females. […] S aureus is the causal agent in all cases of bullous impetigo, and most cases of nonbullous impetigo. Streptococcus pyogenes causes the remaining cases of nonbullous impetigo. […] Patients should be closely followed for response to therapy. If there is suboptimal response to topical therapy, a switch to oral antibiotics would be warranted.

• #39 Impetigo Contagious Symptoms, Causes & Infection Treatment

  https://www.medicinenet.com/impetigo/article.htm

  What tests and procedures diagnose impetigo? […] Diagnosing an impetigo infection is generally straightforward and based on the clinical appearance. Occasionally, other conditions may look something like impetigo. Skin infections such as tinea („ringworm”) or scabies (mites) may be confused with impetigo. It is important to note that not every sore or blister means an impetigo infection. At times, other infected and noninfected skin diseases produce blister-like skin inflammation. Such conditions include herpes cold sores, chickenpox, poison ivy, skin allergies, eczema, and insect bites. […] Medical evaluation and occasionally culture tests are used to decide whether topical antibacterial creams will suffice or whether oral antibiotics will be necessary.

• #40 Impetigo – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/impetigo/symptoms-causes/syc-20352352

  Impetigo is caused by bacteria, usually staphylococci organisms. […] If you suspect that you or your child has impetigo, consult your family doctor, your child’s pediatrician or a dermatologist. […] Treatment with antibiotics can limit the spread of impetigo to others. […] Impetigo typically isn’t dangerous. And the sores in mild forms of the infection generally heal without scarring. […] Rarely, complications of impetigo include: […] The bacteria that cause impetigo often enter the skin through a small cut, insect bite or rash. […] To help prevent impetigo from spreading to others:

• #41 Impetigo: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html

  Impetigo is the most common bacterial skin infection in children two to five years of age. […] The diagnosis of nonbullous and bullous impetigo is nearly always clinical. […] In patients in whom first-line therapy fails, culture of the pus or bullous fluid, not the intact skin, may be helpful for pathogen identification and antimicrobial susceptibilities. […] Although serologic testing for streptococcal antibodies is helpful in the diagnosis of acute poststreptococcal glomerulonephritis, it does not aid in the diagnosis of impetigo. […] Impetigo is usually a self-limited condition, and although rare, complications can occur. […] The number of possible causes, incidence, and clinical severity of acute poststreptococcal glomerulonephritis have decreased, because the causative organism of impetigo has shifted from S. pyogenes to S. aureus.

• #42 Pediatric Impetigo – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/impetigo

  Impetigo is a skin infection. […] Impetigo is most common in children from ages 2 to 5. It is contagious. This means its easily passed from one person to another. […] Symptoms can occur a bit differently in each child. […] The symptoms of impetigo can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis. […] The healthcare provider will ask about your childs symptoms and health history. They will give your child a physical exam. A sample of the pus from the sores may be sent to a lab. This is called a culture. Its done to see what type of bacteria caused the infection. It can help the doctor decide the best antibiotic for treatment. […] Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. […] Possible complications of impetigo can include: Worsening or spreading of the infection. […] You can help to prevent impetigo and prevent it from spreading to others. […] If your child is being treated for impetigo, contact your provider if their symptoms don’t improve or get worse.

• #43 Impetigo – school sores | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/impetigo-school-sores

  Impetigo may be diagnosed by an experienced clinician on the basis of the appearance of the infection. It may also be diagnosed by taking a swab of the blisters or crust and checking for the presence of bacteria. […] Impetigo can be treated with prescription antibiotic ointments or creams, which need to be reapplied until the sores have completely healed. Antibiotic syrups or tablets may also be prescribed. It is important to complete any course of antibiotics you are prescribed. If left untreated, impetigo can lead to skin abscesses.

• #44 Spotting Impetigo: Differential Diagnosis, Key Clinical Clues, and Evidence-Based Treatment Approaches – MDBriefCase

  https://www.mdbriefcase.com/blog/spotting-impetigo-differential-diagnosis-key-clinical-clues-and-evidence-based-treatment-approaches/

  Impetigo is a highly contagious infection in the epidermis or outer layers of the skin, primarily caused by Staphylococci bacteria. The diagnosis is clinical, but it’s critical to consider the patient history, your findings during a physical exam, and lab tests where necessary. […] Impetigo may be easily mistaken for other diseases, but a few signs and symptoms can help you identify the condition. Patients may describe a painless itchy rash with red spots progressing to fluid-filled blisters. […] The golden-yellow crust is the tell-tale sign of impetigo. It appears as the blisters rupture and leak yellow pus that dries. […] Impetigo often clears with treatment within five days. However, early treatment is essential to prevent scarring, cellulitis, or hyper- or hypopigmentation. […] Antibiotics are the primary treatment for impetigo. You can prescribe topical or oral antibiotics, though a topical form is as effective for mild or moderate impetigo with fewer side effects. […] Impetigo is highly contagious and spreads through direct contact with the rash or contaminated personal items such as linens, towels, and facecloths.

• #45 Impetigo – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430974/

  While untreated impetigo is often self-limiting, antibiotics decrease the duration of illness and spread of lesions. […] For localized, uncomplicated, non-bullous impetigo, topical therapy alone is the treatment of choice. […] Systemic antibiotics should be prescribed for all cases of bullous impetigo and cases of non-bullous impetigo with more than five lesions, deep tissue involvement, systemic signs of infection, lymphadenopathy or lesions in the oral cavity. […] History and physical exam are essential to the diagnosis of impetigo.

• #46 Impetigo | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/impetigo-16689666.html

  Impetigo is a benign, contagious infection of the epidermis due to group A -haemolytic streptococcus and Staphylococcus aureus. Co-infection is common. […] Primary infections are most common in children. Secondary infections complicating preexisting pruritic dermatoses (lice, scabies, eczema, herpes, chickenpox, etc.) are more common in adults. […] Regardless of the type of impetigo: absence of fever or systemic signs. […] Acute glomerulonephritis (routinely look for signs of glomerulonephritis). […] Localised non bullous impetigo (max. 5 lesions in a single skin area): Clean with soap and water and dry before applying mupirocin. […] Extensive non bullous impetigo (more than 5 lesions or impetigo involving more than one skin area), bullous impetigo, ecthyma, impetigo with abscess; immunocompromised patient; topical treatment failure: Clean with soap and water and dry 2 to 3 times daily. […] Quarantine from school (children can return to school after 24 to 48 hours of antibiotic therapy).

• #47 Impetigo: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html

  There is no clear evidence-based preference among the different classes of oral antibiotics. […] Comparison studies also show no significant difference in cure rates between topical and oral antibiotics. […] If MRSA infection is suspected, initial treatment with trimethoprim/sulfamethoxazole, clindamycin, or a tetracycline (doxycycline or minocycline [Minocin]) is recommended pending culture results. […] The evidence is insufficient to recommend or dismiss popular herbal treatments for impetigo. […] Future treatments for impetigo might include minocycline foam (Foamix), which has successfully completed phase II trials, and Ozenoxacin, a topical quinolone that has successfully completed phase III clinical trials.

• #48 Impetigo Treatment, Symptoms, Definition, Causes

  https://www.emedicinehealth.com/impetigo/article_em.htm

  How Do Medical Professionals Diagnose Impetigo? […] Doctors can usually distinguish an impetigo rash by looking at it. No lab tests are required. Occasionally rashes and blisters caused by toxins, such as poison ivy, or others might be confused with impetigo. A doctor will take a complete history to determine the appropriate diagnosis and treatment. […] The physician will typically prescribe oral or topical antibiotics or both. […] Topical: Topical antibiotic treatment is with a prescription-strength medication called mupirocin (Bactroban). Most nonprescription antibiotic ointments, such as Neosporin, are not effective. This is generally the first line of treatment for nonbullous impetigo, localized to a single area […] Oral: Usually oral antibiotics are reserved for more serious cases of impetigo, including bullous impetigo. The most common types of antibiotics taken as pills are types of penicillin or related medications called cephalosporins. If someone has a penicillin allergy, the treatment is usually with erythromycin (or other similar medicines such as clarithromycin [Biaxin] or azithromycin [Zithromax]). For some infections caused by resistant bacteria, clindamycin or trimethoprim-sulfamethoxazole (Bactrim) may be required.

• #49 How to Get Rid of Impetigo: Treatment Options

  https://www.everydayhealth.com/impetigo/treatment/

  Oza says if the impetigo is confined to a small area and doesnt seem to go deep into the skin, hed recommend treating the area with a topical antibiotic. […] Instead, a doctor will likely recommend a topical antibiotic, such as ozenoxacin (Xepi), mupirocin (Bactroban), retapamulin (Altabax), or fusidic acid. (1) It should be applied directly to the sores on the body. […] If the topical treatments arent effective or if the impetigo has spread to other parts of the body, it may be time for an oral antibiotic. Oza says hed likely prescribe one for 7 to 10 days, though youll probably see results much sooner. […] Even if the infection clears up before then, youll want to take all of the antibiotics the doctor prescribed to reduce the chances of it coming back. (5) […] If you follow these treatment methods and the impetigo doesnt go away or worse it continues to spread or is accompanied by swelling, pain, or a fever, its time to visit the doctor again. (3)

• #50 Impetigo: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0815/p229.html

  There is no clear evidence-based preference among the different classes of oral antibiotics. […] Comparison studies also show no significant difference in cure rates between topical and oral antibiotics. […] If MRSA infection is suspected, initial treatment with trimethoprim/sulfamethoxazole, clindamycin, or a tetracycline (doxycycline or minocycline [Minocin]) is recommended pending culture results. […] The evidence is insufficient to recommend or dismiss popular herbal treatments for impetigo. […] Future treatments for impetigo might include minocycline foam (Foamix), which has successfully completed phase II trials, and Ozenoxacin, a topical quinolone that has successfully completed phase III clinical trials.

• #51 Impetigo | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23410

  Diagnosis is typically based on the symptoms and clinical manifestations alone. […] History and physical exam are essential to the diagnosis of impetigo. Bacterial cultures can be used for confirmation of diagnosis and should be obtained if methicillin-resistant staph aureus (MRSA) is suspected or if an impetigo outbreak is present. […] The anti-streptolysin O (ASO) response is weak from impetigo alone. Therefore, serologic testing for streptococcal antibodies is not indicated for the diagnosis of impetigo. However, it may be useful if post-streptococcal glomerulonephritis is suspected in a patient with a recent impetigo outbreak. […] Evaluation for carriage of the causative bacteria should be performed. The nose is a common reservoir and carriers can be treated with mupirocin (Bactroban Nasal) applied in the nostrils.

• #52 Impetigo and Ecthyma – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/impetigo-and-ecthyma

  Impetigo is a superficial skin infection with crusting or bullae caused by streptococci, staphylococci, or both. […] Diagnosis is clinical. […] Diagnosis of impetigo and ecthyma is by characteristic appearance. […] Cultures of lesions are indicated only when the patient does not respond to empiric therapy. […] Patients with recurrent impetigo should have nasal culture. […] Persistent infections should be cultured to identify MRSA. […] For persistent impetigo, culture the lesion (to identify methicillin-resistant S. aureus [MRSA]) and the nose (to identify a potential nasal reservoir).

• #53 Impetigo (school sores)

  https://www.rch.org.au/kidsinfo/fact_sheets/impetigo_school_sores/

  Impetigo (school sores) is an infection of the skin caused by bacteria. It is often called school sores because it is common among school children. Impetigo causes sores on the skin, which are usually itchy. The sores may start out as blisters that burst and become weepy, before being covered with a crust. […] Impetigo is not usually a serious infection, and should clear up a few days after starting medical treatment. Children with impetigo are very infectious (contagious), but the spread of impetigo can be reduced by practising good hygiene, covering the sores with dressings and keeping your child away from other children until they are no longer infectious. […] If your child has signs and symptoms of impetigo, take them to see a GP. The doctor will make sure the sores are impetigo. […] Your doctor may prescribe antibiotic medicine in the form of a cream, ointment, tablets or syrup. Give these to your child as directed, and make sure you complete the course of antibiotics.

• #54

• #55 About Impetigo | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/about/impetigo.html

  Healthcare providers typically diagnose impetigo by looking at the sores during a physical examination. Lab tests are not needed. […] People with impetigo can return to work, school, or daycare if they have started antibiotic treatment. They should also cover all sores on exposed skin.

• #56 Impetigo (school sores)

  https://www.rch.org.au/kidsinfo/fact_sheets/impetigo_school_sores/

  Impetigo is very infectious and can be easily spread to other children. […] Complete all courses of antibiotics as prescribed and continue treatment with creams or ointments until all sores are healed. […] Your child can go back to child care, kindergarten or school after 24 hours of treatment and when the sores are completely covered with dressings.

• #57 How to Get Rid of Impetigo: Treatment Options

  https://www.everydayhealth.com/impetigo/treatment/

  Generally, the infection is contagious until the scabs come off or the rash disappears. (7) But Denike says the child is no longer contagious 24 hours after starting antibiotics. […] Moderate to severe infections may require a visit to the doctor for a round of topical or oral antibiotics. […] To help prevent impetigo, experts recommend treating and covering broken skin, since it often develops in places where the skin has an abrasion.

• #58 Impetigo in Children

  https://www.nationwidechildrens.org/conditions/health-library/impetigo-in-children

  How is impetigo diagnosed in a child? The healthcare provider will ask about your childs symptoms and health history. They will give your child a physical exam. A sample of the pus from the sores may be sent to a lab. This is called a culture. Its done to see what type of bacteria caused the infection. It can help the healthcare provider decide the best antibiotic for treatment. […] Impetigo is an infection that affects the skin. Its caused by bacteria and can spread from one person to another. […] Impetigo is often treated with antibiotic cream, ointment, pills, or liquid. […] Keeping the skin clean may help to prevent the spread of impetigo. It is very important to scrub your hands with soap and warm water for at least 20 seconds before and after caring for your child. […] Your child can return to daycare or school 48 hours after starting antibiotic treatment as long as there are signs of improvement.

• #59 Chapter 4: Impetigo

  https://themedicalxchange.com/en/review/2511_chapter-4-impetigo/

  Impetigo is a common bacterial infection of the superficial skin that most commonly occurs among children. […] The diagnosis of impetigo is based on clinical examination. […] Although bacteria are the cause of impetigo, skin swabs are considered unhelpful in diagnosis because they do not reliably distinguish between infectious and resident organisms. […] Based on a probable diagnosis, treatment can be initiated without steps to identify the pathogen. […] However, if first-line therapy fails, culture of the pus or bullous fluid is a reasonable step to identify the infecting pathogen and its susceptibilities. […] The differential diagnosis is specific to the nonbullous and bullous presentations. […] Topical antibacterial agents are effective for most cases of impetigo, which resolve readily with treatment.

• #60 Chapter 4: Impetigo

  https://themedicalxchange.com/en/review/2511_chapter-4-impetigo/

  Referrals are most appropriate when the diagnosis is uncertain or the lesions do not resolve readily with appropriate treatment. […] Impetigo is an infectious disease readily managed by primary care physicians. […] Although it is important to consider resistant organisms, including MRSA, in patients who do not respond to first-line therapies, the referral in serious and progressive infections should be made to an infectious disease specialist or a dermatologist or allergist when there is diagnostic uncertainty. […] Even though impetigo is a self-limited superficial bacterial infection of the skin in most cases, early diagnosis and treatment facilitate healing and reduce risk of transmission.

• #61 Impetigo: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/965254-overview

  Impetigo is the most common bacterial infection in children. This acute, highly contagious infection of the superficial layers of the epidermis is primarily caused by Streptococcus pyogenes or Staphylococcus aureus. […] The diagnosis of impetigo is usually made on the basis of the history and physical examination. However, bacterial culture and sensitivity can be used to confirm the diagnosis and are recommended in the following scenarios: When MRSA is suspected, in the presence of an impetigo outbreak, in the presence of poststreptococcal glomerulonephritis (PSGN); in such cases, urinalysis is also necessary. […] Diagnosis of impetigo is usually based solely on the history and clinical appearance. Treatment typically involves local wound care, along with antibiotic therapy, either topical or systemic plus topical.

• #62 Impetigo: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/impetigo-treatment

  A dermatologist can often diagnose impetigo by looking at your skin. […] Sometimes, lab tests are necessary to give you the diagnosis, or to get information necessary to treat you. […] If your dermatologist thinks that the infection could be widespread, you may need a blood test. […] Dermatologists recommend treating impetigo. It can help cure the impetigo and prevent others from getting this highly contagious skin infection. […] With treatment, impetigo is usually no longer contagious within 24 to 48 hours. […] If you see anything on your skin that looks infected, its best to see a board-certified dermatologist as soon as possible. An early diagnosis and treatment can prevent complications and help you feel better.

• #63 What Is Impetigo? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/impetigo/guide/

  Impetigo can occur in anyone, but its more common in children and infants than adults. (1) This is a highly contagious bacterial skin infection, with the first signs including tiny bumps or blisters that form on different parts of the body, such as the face, the hands, and the feet. As impetigo progresses, the sores eventually rupture and develop honey-colored or yellowish scabs. (2) Even though impetigo goes away on its own within two to six weeks, treatment is recommended due to the contagious nature of this skin infection. (4) See a doctor if you or your child develops sores or blisters, or if you suspect impetigo. […] While many doctors and dermatologists can make a diagnosis of impetigo by looking at the skin, taking a culture from the area can help them identify what type of bacteria it is and which antibiotic it will respond to, if the case is more involved. (4) A doctor or dermatologist can usually identify impetigo by examining the look and location of lesions. For this reason, lab tests arent usually necessary. (4,11) But if theres any ambiguity, your doctor may want to examine a sample of the pus to confirm the presence of bacteria. Taking a sample from the sore can also help your doctor determine which antibiotic will work best to clear the infection. (4)

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