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  • Superficial pyoderma

  • Streptococcal impetigo

  • Impetigo contagiosa




  • 041.01 Streptococcus infection in conditions classified elsewhere and of unspecified site, Streptococcus, group A




  • B95.0 Streptococcus, group A, as the cause of diseases classified elsewhere




  • 7B: Impaired Integumentary Integrity Secondary to Superficial Skin Involvement



A 62-year-old male presents with swelling, pain, and discoloration of the right foot. His wife reports that he stepped on a sharp object on the floor 3 days ago. He now has fever, diarrhea, and is showing some confusion. The patient has no complaints of pain. He has a history of type II diabetes. Because of the possible associated and unidentifiable fever and confusion the patient was referred to a walk in medical clinic.




  • Streptococcus pyogenes (group A Streptococcus) is responsible for infections in the skin

  • Group A infections

    • Cellulitis and erysipelas

    • Impetigo

    • Scarlet fever

    • Severe strep infections

  • Highly infectious skin rash, spreads rapidly

  • It occurs most often in tropical climates or during the summer months in nontropical climates

  • With this infection, the patient is usually afebrile and has no pain

  • Lesions are most often on the face and extremities and may become a mild but chronic illness if untreated

  • Most common in children, particularly those in unhealthy living conditions

  • In adults, it may follow other skin disorders or a recent upper respiratory infection, such as a cold or other virus

  • Preceding a streptococcal respiratory infection

Essentials of Diagnosis

  • Diagnosis is usually made by considering medical history and signs and symptoms, including the distinctive sores.

  • A culture may be used to confirm the diagnosis or to rule out another cause.

General Considerations

  • Highly contagious and can be spread through close contact or sharing items.

  • Scratching can spread the sores to other parts of the body.

  • It can be difficult to distinguish clinically between skin infection caused by streptococci and other bacteria such as Staphylococcus


Structure of the skin. (From Chandrasoma P, Taylor CR. Concise Pathology. 3rd ed. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location

  • Highest prevalence in children 2 to 5 years of age

  • Can be seen in adults, but is more prevalent in children





  • Impetigo

  • Erysipelas

  • Rash

  • Blisters filled with pus

  • Fever

  • Malaise

  • Vomiting: Childhood type

  • Itching blister

  • Erythematous denuded areas

  • Honey-colored crusts

  • Localized area of redness

  • Purulent vesicles covered with a thick, confluent, honey-colored fluid

  • Swollen lymph nodes near the ...

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