57: SKIN INFECTIONS, STREPTOCOCCAL

CONDITION/DISORDER SYNONYMS

• Superficial pyoderma

• Streptococcal impetigo

• Impetigo contagiosa

ICD-9-CM CODE

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

ICD-10-CM CODE

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

PREFERRED PRACTICE PATTERN¹

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

KEY FEATURES

Description

• 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

Demographics

• Highest prevalence in children 2 to 5 years of age

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

CLINICAL FINDINGS