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  • Superficial pyoderma
  • Streptococcal impetigo
  • Impetigo contagiosa

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

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

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Description

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  • Streptococcus pyogenes (group A Streptococcus) is responsible for infections in the skin
  • Highly infectious skin rash, spreads rapidly
  • It occurs most often in tropical climates or during the summer months in non-tropical 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

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Essentials of Diagnosis

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  • 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

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General Considerations

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  • 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

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Demographics

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  • Highest prevalence in children 2 to 5 years of age
  • Can be seen in adults, but is more prevalent in children

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Signs and Symptoms

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  • 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 infection
  • Lesions most often on face, lips, arms, and legs

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Functional Implications

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  • Very contagious, limiting contact and social status

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Possible Contributing Causes

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  • Skin lesions
  • Circulation impairment
  • Pain
  • Edema
  • Contact with someone with the skin infection

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Differential Diagnosis

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  • Tinea
  • Herpetic impetigo
  • Pemphigus vulgaris
  • Pemphigus foliaceus
  • Folliculitis
  • Pseudomonas folliculitis
  • Follicular mucinosis
  • Erysipelas
  • Lymphadenitis
  • Lymphadenopathy
  • S. aureus infection
  • Insect bites

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Laboratory Tests

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  • Culture of the skin or lesion
  • Blood cultures: leukocytosis tests

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Medication

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  • Allergist/immunologist
  • Dermatologist

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  • Skin integrity
  • Circulation
  • Pain
  • Sensation
  • Joint ROM
  • Muscle strength
  • Functional mobility
  • Self-care
  • Home management

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  • Integumentary integrity
    • Pigmentation
    • Shape and size of skin involvement
    • Presence of rash, fungi, blistering, ecchymosis, hair growth, signs of infection
    • Skin temperature
    • Tissue mobility: turgor, texture
  • Circulation
    • Capillary refill, palpation of pulses
  • Volume ...

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