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CONDITION/DISORDER SYNONYMS
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Superficial pyoderma
Streptococcal impetigo
Impetigo contagiosa
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PREFERRED PRACTICE PATTERN1
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PATIENT PRESENTATION
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.
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Streptococcus pyogenes (group A Streptococcus) is responsible for infections in the skin
Group A 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
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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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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
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, ...