Impetigo
Fusidic Acid
Exfoliatins
Staphylococcal Scalded Skin Syndrome
Fiji
Dermatitis Herpetiformis
Scabies
Streptococcus pyogenes
Dermatitis, Exfoliative
Staphylococcus aureus
Administration, Topical
Selective distribution of a high-affinity plasminogen-binding site among group A streptococci associated with impetigo. (1/81)
Group A streptococci can be classified according to their tendency to cause either impetigo, pharyngitis, or both types of infection. Genotypic markers for tissue site preference lie within emm genes, which encode fibrillar surface proteins that play a key role in virulence. emm gene products (M and M-like proteins) display an extensive array of binding activities for tissue and plasma proteins of the human host. In a previous study, a high-affinity binding site for human plasmin(ogen) was mapped to the emm53 gene product. In this report, a structurally similar plasminogen-binding domain is found to be widely and selectively distributed among group A streptococci harboring the emm gene marker for the skin as the preferred tissue site for infection. The findings are highly suggestive of a central role for bacterial modulation of host plasmin(ogen) during localized infection at the epidermis. (+info)Efficacy of a new cream formulation of mupirocin: comparison with oral and topical agents in experimental skin infections. (2/81)
A new cream formulation of mupirocin developed to improve patient compliance was compared with systemic and topical antibiotics commonly used to treat primary and secondary skin infections. A mouse surgical wound model infected with Staphylococcus aureus or Streptococcus pyogenes was used. Topical treatment was applied at 4 and 10 h postinfection or oral treatment at a clinically relevant dose was administered 4, 8, and 12 h postinfection; treatments were continued three times daily for a further 3 days. Mupirocin cream was significantly more effective than (P < 0.01; two of eight studies) or not significantly different from (six of eight studies) mupirocin ointment in reducing bacterial numbers. Mupirocin cream was similar in efficacy to oral flucloxacillin but significantly more effective (P < 0.001) than oral erythromycin. It was also similar in efficacy to cephalexin against S. pyogenes but superior against S. aureus (P < 0.01). Mupirocin cream had a similar efficacy to fusidic acid cream against S. aureus but was significantly superior against S. pyogenes (P < 0.01). A hamster impetigo model infected with S. aureus was also used. Topical or oral treatment was administered at 24 and 30 h postinfection (also 36 h postinfection for oral therapy) and then three times daily for a further 2 days. On day 5, mupirocin cream was significantly more effective than mupirocin ointment in one study (P < 0.01) and of similar efficacy in the other two studies. Mupirocin cream was not significantly different from fusidic acid cream or neomycin-bacitracin cream, but it was significantly superior (P < 0.01) to oral erythromycin and cephalexin. Mupirocin cream was as effective as, or superior to, oral and other topical agents commonly used for skin infections. (+info)Epidemiological analysis of non-M-typeable group A Streptococcus isolates from a Thai population in northern Thailand. (3/81)
Infection with group A streptococci (GAS) can lead to the development of severe postinfectious sequelae such as rheumatic fever (RF). In Thailand, RF and rheumatic heart disease (RHD) remain important health problems. More than 80% of GAS circulating in this population are non-M antigen typeable by conventional M serotyping methods. In this study, we determine the M protein sequence types of GAS isolates found in northern Thailand. The emm genes from 53 GAS isolates, collected between 1985 and 1995 from individuals with pharyngitis, impetigo, acute RF (ARF), RHD, or meningitis as well as from individuals without infections, were amplified by PCR and sequenced. Thirteen new sequence types that did not show homology to previously published sequences were characterized. Six of these sequence types could be isolated from both skin and throat sites of impetigo and pharyngitis/ARF patients, respectively. In many cases we could not specifically differentiate skin strains or throat strains that could be associated with ARF or acute glomerulonephritis. Antigenic variations in the emm gene of the isolates investigated, compared to published M protein sequences, were predominantly due to point mutations, small deletions, and insertions in the hypervariable region. One group of isolates with homology to M44 exhibited corrected frameshift mutations. A new M type isolated from an RHD patient exhibited nucleotide sequence corresponding to the N terminus of M58 and the C terminus of M25, suggesting that recombination between the two types may have occurred. This study provided epidemiological data relating to GAS endemic to northern Thailand which could be useful for identification of vaccine candidates in a specific region of endemicity. (+info)Humanized in vivo model for streptococcal impetigo. (4/81)
An in vivo model for group A streptococcal (GAS) impetigo was developed, whereby human neonatal foreskin engrafted onto SCID mice was superficially damaged and bacteria were topically applied. Severe infection, indicated by a purulent exudate, could be induced with as few as 1,000 CFU of a virulent strain. Early findings (48 h) showed a loss of stratum corneum and adherence of short chains of gram-positive cocci to the external surface of granular keratinocytes. This was followed by an increasing infiltration of polymorphonuclear leukocytes (neutrophils) of mouse origin, until a thick layer of pus covered an intact epidermis, with massive clumps of cocci accumulated at the outer rim of the pus layer. By 7 days postinoculation, the epidermis was heavily eroded; in some instances, the dermis contained pockets (ulcers) filled with cocci, similar to that observed for ecthyma. Importantly, virulent GAS underwent reproduction, resulting in a net increase in CFU of 20- to 14,000-fold. The majority of emm pattern D strains had a higher gross pathology score than emm pattern A, B, or C (A-C) strains, consistent with epidemiological findings that pattern D strains have a strong tendency to cause impetigo, whereas pattern A-C strains are more likely to cause pharyngitis. (+info)Contrasting molecular epidemiology of group A streptococci causing tropical and nontropical infections of the skin and throat. (5/81)
Disease caused by group A streptococci (GAS) in tropical regions often takes the form of impetigo, whereas pharyngitis tends to predominate in temperate zones. GAS derived from asymptomatic throat infections and pyoderma lesions of rural Aboriginal Australians were evaluated for phylogenetic distant emm genes, which represent ecological markers for tissue site preference. On the basis of the percentage of total isolates from a given tissue, emm pattern A-C organisms exhibited a stronger predilection for the throat, whereas pattern D organisms preferred the skin. Only 16% of isolates collected by active surveillance displayed pattern A-C, which reflects the low incidence of oropharyngeal infection. Importantly, most (70%) pattern A-C organisms were isolated from skin sores, despite their innate tendency to infect the throat. Combined with findings from nontropical populations, analysis of the data supports the hypothesis that GAS tissue preferences are genetically predetermined and that host risk factors for infection strongly influence the differential reproduction of individual clones. (+info)Enumeration of beta-haemolytic streptococci on normal skin by direct agar contact. (6/81)
Normal skin sites in children from a population in which streptococcal impetigo is endemic were examined for the presence of beta-haemolytic streptococci by a direct agar-contact technique. Ninety-eight of 554 samples (18%) were positive for these organisms. Penicillin prophylaxis reduced the frequency of isolation of streptococci from the normal skin for a period of 3 weeks, perhaps accounting in part for the lower isolation rate in this than in earlier studies. Numbers of streptococcal colony-forming units in positive samples were generally low, both in terms of absolute numbers isolated from the surface area sampled and in comparison with numbers of other aerobic flora recovered. The presence of streptococcal pyoderma at the time of agar contact was not necessarily associated with the presence of or with increased numbers of streptococci on samples obtained from normal skin sites. Low counts were consistently found in early summer and higher counts in some samples in late summer. In a simultaneous comparison of paired samples taken from adjacent sites, the frequency of detection of streptococci by direct agar contact compared favourably with that obtained with a moist-swab method. The increased frequency of detection by the agar-contact method appeared to be related to an increased sensitivity for the detection of low numbers of streptococcal colony-forming units on the normal skin. (+info)Staphylococcus aureus isolated in cases of impetigo produces both epidermolysin A or B and LukE-LukD in 78% of 131 retrospective and prospective cases. (7/81)
Clinical symptoms of impetigo and staphylococcal scalded skin syndrome may not only be expressed as the splitting of cell layers within the epidermis but are often accompanied by some localized inflammation. Toxin patterns of Staphylococcus aureus isolates originating from patients with impetigo and also from those with other primary and secondary skin infections in a retrospective isolate collection in France and a prospective isolate collection in French Guiana revealed a significant association (75% of the cases studied) of impetigo with production of at least one of the epidermolysins A and B and the bicomponent leucotoxin LukE-LukD (P < 0.001). However, most of the isolates were able to produce one of the nonubiquitous enterotoxins. Pulsed-field gel electrophoresis (PFGE) of genomic DNA hydrolyzed with SmaI showed a polymorphism of the two groups of isolates despite the fact that endemic clones were suspected in French Guiana and France. The combination of toxin patterns with PFGE fingerprinting may provide further discrimination among isolates defined in a given cluster or a given pulsotype and account for a specific virulence. The new association of toxins with a clinical syndrome may reveal principles of the pathological process. (+info)Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial. (8/81)
OBJECTIVE: To test the hypothesis that fusidic acid would not increase the treatment effect of disinfecting with povidone-iodine alone in children with impetigo. DESIGN: Randomised placebo controlled trial. SETTING: General practices in Greater Rotterdam. PARTICIPANTS: 184 children aged 0-12 years with impetigo. MAIN OUTCOME MEASURES: Clinical cure and bacterial cure after one week. RESULTS: After one week of treatment 55% of the patients in the fusidic acid group were clinically cured compared with 13% in the placebo group (odds ratio 12.6, 95% confidence interval 5.0 to 31.5, number needed to treat 2.3). After two weeks and four weeks the differences in cure rates between the two groups had become smaller. More children in the placebo group were non-compliant (12 v 5) and received extra antibiotic treatment (11 v 3), and more children in the placebo group reported adverse effects (19 v 7). Staphylococcus aureus was found in 96% of the positive cultures; no strains were resistant to fusidic acid. CONCLUSIONS: Fusidic acid is much more effective than placebo (when both are given in combination with povidone-iodine shampoo) in the treatment of impetigo. Because of the low rate of cure and high rate of adverse events in the placebo group, the value of povidone-iodine in impetigo can be questioned. (+info)Impetigo is a common and highly contagious skin infection that mainly affects infants and children. It is caused by two types of bacteria, namely Staphylococcus aureus and Streptococcus pyogenes (Group A streptococcus). The infection typically occurs in areas of the body with broken or damaged skin, such as cuts, scrapes, insect bites, or rashes.
There are two forms of impetigo: non-bullous and bullous. Non-bullous impetigo, also known as crusted impetigo, begins as small blisters or pimples that quickly rupture, leaving a yellowish-crusted, honey-colored scab. These lesions can be itchy and painful, and they often occur around the nose, mouth, and hands. Non-bullous impetigo is more commonly caused by Streptococcus pyogenes.
Bullous impetigo, on the other hand, is characterized by larger fluid-filled blisters that are usually painless and do not itch. These blisters can appear anywhere on the body but are most common in warm, moist areas such as the armpits, groin, or diaper region. Bullous impetigo is primarily caused by Staphylococcus aureus.
Impetigo is typically treated with topical antibiotics, such as mupirocin (Bactroban) or retapamulin (Altabax), applied directly to the affected area. In more severe cases, oral antibiotics may be prescribed. It is essential to cover the lesions and maintain good hygiene practices to prevent the spread of impetigo to others.
Fusidic Acid is a steroid antibiotic, derived from the fungus Fusidium coccineum. It is primarily used to treat skin infections and other susceptible bacterial infections. It works by inhibiting bacterial protein synthesis. In medical terms, it can be defined as:
A triterpenoid antibiotic derived from the fungus Fusidium coccineum, used primarily to treat staphylococcal and streptococcal skin infections that are resistant to other antibiotics. It inhibits bacterial protein synthesis by binding to the bacterial elongation factor EF-G, preventing translocation of peptidyl tRNA from the A site to the P site on the ribosome.
It is important to note that resistance to fusidic acid can develop and its use should be reserved for infections caused by organisms known to be susceptible to it. It is not typically used as a first-line antibiotic, but rather as a secondary option when other treatments have failed or are contraindicated.
I'm sorry for any confusion, but "Exfoliatins" is not a recognized medical term or a known medical condition. It seems like there might be a spelling mistake or a mix-up with the terminology. Exfoliation refers to the natural process of shedding dead skin cells from the surface of the skin. If you have any specific concerns about skin issues or other health problems, I would recommend consulting a healthcare professional for accurate information and advice tailored to your situation.
Staphylococcal Scalded Skin Syndrome (SSSS) is a cutaneous condition, primarily seen in infants and young children, characterized by widespread, superficial blistering and sloughing of the skin, which gives the appearance of a burn or scald. It's caused by certain strains of Staphylococcus aureus bacteria that produce exfoliative toxins (ETs), specifically ET-A and ET-B, which can cause epidermal separation at the granular layer.
The condition often begins with symptoms such as fever, irritability, and skin tenderness. Within 24 to 48 hours, large, flaccid blisters develop, usually first on the face and perioral area, and then spread to other parts of the body. The blisters are fragile and easily rupture, leading to widespread, shallow areas of denuded skin. The affected areas are red, painful, and can be mistaken for a burn or scald injury.
Despite its appearance, SSSS is not a true infection of the deeper layers of the skin but rather a reaction to the toxins produced by the Staphylococcus aureus bacteria. The condition is usually treated with systemic antibiotics active against Staphylococcus aureus, as well as supportive care for the damaged skin, such as wound dressings and pain management. Prompt treatment typically leads to a good prognosis, although severe cases can lead to complications like dehydration, sepsis, or even death in rare instances.
A blister is a small fluid-filled bubble that forms on the skin due to friction, burns, or contact with certain chemicals or irritants. Blisters are typically filled with a clear fluid called serum, which is a component of blood. They can also be filled with blood (known as blood blisters) if the blister is caused by a more severe injury.
Blisters act as a natural protective barrier for the underlying skin and tissues, preventing infection and promoting healing. It's generally recommended to leave blisters intact and avoid breaking them, as doing so can increase the risk of infection and delay healing. If a blister is particularly large or painful, medical attention may be necessary to prevent complications.
I'm sorry for any confusion, but "Fiji" is not a medical term. It is a country in the South Pacific Ocean, officially known as the Republic of Fiji, consisting of more than 300 islands. If you have any questions about medical terms or concepts, I would be happy to help with those!
Dermatitis herpetiformis (DH) is a chronic, autoimmune blistering skin disorder that is characterized by the presence of symmetrical, pruritic (itchy), papulo-vesicular (papules and small fluid-filled blisters) eruptions on the extensor surfaces of the body, such as the elbows, knees, buttocks, and shoulders. It is often associated with gluten sensitivity or celiac disease, a condition that causes an abnormal immune response to gluten, a protein found in wheat, barley, and rye.
The exact cause of DH is not fully understood, but it is believed to result from the interaction between genetic, environmental, and immunological factors. The disorder is characterized by the presence of IgA antibodies in the skin, which trigger an immune response that leads to the formation of the characteristic rash.
DH is typically treated with a gluten-free diet, which can help to control the symptoms and prevent complications such as malabsorption and nutritional deficiencies. Medications such as dapsone may also be used to control the itching and blistering associated with the disorder. In some cases, topical corticosteroids or other anti-inflammatory medications may be prescribed to help manage symptoms.
It is important to note that DH is a chronic condition that requires ongoing management and monitoring. People with DH should work closely with their healthcare provider to develop an appropriate treatment plan and monitor their progress over time.
Scabies is a contagious skin condition caused by the infestation of the human itch mite (Sarcoptes scabiei var. hominis). The female mite burrows into the upper layer of the skin, where it lays its eggs and causes an intensely pruritic (itchy) rash. The rash is often accompanied by small red bumps and blisters, typically found in areas such as the hands, wrists, elbows, armpits, waistline, genitals, and buttocks. Scabies is transmitted through direct skin-to-skin contact with an infected individual or through sharing of contaminated items like bedding or clothing. It can affect people of all ages, races, and socioeconomic backgrounds, but it is particularly common in crowded living conditions, nursing homes, and child care facilities. Treatment usually involves topical medications or oral drugs that kill the mites and their eggs, as well as thorough cleaning and laundering of bedding, clothing, and towels to prevent reinfestation.
Streptococcus pyogenes is a Gram-positive, beta-hemolytic streptococcus bacterium that causes various suppurative (pus-forming) and nonsuppurative infections in humans. It is also known as group A Streptococcus (GAS) due to its ability to produce the M protein, which confers type-specific antigenicity and allows for serological classification into more than 200 distinct Lancefield groups.
S. pyogenes is responsible for a wide range of clinical manifestations, including pharyngitis (strep throat), impetigo, cellulitis, erysipelas, scarlet fever, rheumatic fever, and acute poststreptococcal glomerulonephritis. In rare cases, it can lead to invasive diseases such as necrotizing fasciitis (flesh-eating disease) and streptococcal toxic shock syndrome (STSS).
The bacterium is typically transmitted through respiratory droplets or direct contact with infected skin lesions. Effective prevention strategies include good hygiene practices, such as frequent handwashing and avoiding sharing personal items, as well as prompt recognition and treatment of infections to prevent spread.
Exfoliative dermatitis is a severe form of widespread inflammation of the skin (dermatitis), characterized by widespread scaling and redness, leading to the shedding of large sheets of skin. It can be caused by various factors such as drug reactions, underlying medical conditions (like lymphoma or leukemia), or extensive eczema. Treatment typically involves identifying and removing the cause, along with supportive care, such as moisturizers and medications to control inflammation and itching. In severe cases, hospitalization may be necessary for close monitoring and management of fluid and electrolyte balance.
Staphylococcus aureus is a type of gram-positive, round (coccal) bacterium that is commonly found on the skin and mucous membranes of warm-blooded animals and humans. It is a facultative anaerobe, which means it can grow in the presence or absence of oxygen.
Staphylococcus aureus is known to cause a wide range of infections, from mild skin infections such as pimples, impetigo, and furuncles (boils) to more severe and potentially life-threatening infections such as pneumonia, endocarditis, osteomyelitis, and sepsis. It can also cause food poisoning and toxic shock syndrome.
The bacterium is often resistant to multiple antibiotics, including methicillin, which has led to the emergence of methicillin-resistant Staphylococcus aureus (MRSA) strains that are difficult to treat. Proper hand hygiene and infection control practices are critical in preventing the spread of Staphylococcus aureus and MRSA.
Topical administration refers to a route of administering a medication or treatment directly to a specific area of the body, such as the skin, mucous membranes, or eyes. This method allows the drug to be applied directly to the site where it is needed, which can increase its effectiveness and reduce potential side effects compared to systemic administration (taking the medication by mouth or injecting it into a vein or muscle).
Topical medications come in various forms, including creams, ointments, gels, lotions, solutions, sprays, and patches. They may be used to treat localized conditions such as skin infections, rashes, inflammation, or pain, or to deliver medication to the eyes or mucous membranes for local or systemic effects.
When applying topical medications, it is important to follow the instructions carefully to ensure proper absorption and avoid irritation or other adverse reactions. This may include cleaning the area before application, covering the treated area with a dressing, or avoiding exposure to sunlight or water after application, depending on the specific medication and its intended use.