Impetigo

Impetigo is a highly contagious bacterial infection with gram-positive surface layer of the epidermis. The two forms of the disease are bullous impetigo and impetigo nonbulos. Impetigo is caused by Staphylococcus aureus si streptococi beta-hemolitici de grup A precum Streptococcus pyogenes. Ambele organisme pot fi prezente in acelasi timp in zona afectata. Staphylococcus aureus and streptococcus group A beta-hemolytic Streptococcus pyogenes as well. Both bodies may be present simultaneously in the affected area.

Infectia cu Staphylococcus aureus poate fi precedata de o infectie primara cu streptococi. S. Staphylococcus aureus infection may be preceded by a primary infection with streptococcus. S. aureus meticilin rezistent MRSA care poate fi achizitionat din comunitati sau spital a fost observat drept cauza a impetigo. aureus methicillin-resistant MRSA may be purchased from the community or hospital was seen as the cause of impetigo. Aceasta infectie este descrisa mai frecvent cu forma nonbuloasa a impetigo fata de cea buloasa. Staphylococcus aureus este agent etiologic mai frecvent in tarile dezvoltate iar Streptococcus pyogenes in cele nedezvoltate. This infection is commonly described as the nonbuloasa against the bullous impetigo. Staphylococcus aureus is the most common etiologic agent in developed and undeveloped in the Streptococcus pyogenes. Cele mai multe infectii debuteaza cu o infectie streptococica, dar stafilococii inlocuiesc streptococii in evolutie. Most infections begin with a strep infection, but staphylococci streptococci replace evolving.

In timp ce impetigo se poate manifesta ca o piodermita a pielii intacte, poate apare si ca o infectie secundara a unei boli de piele preexistente sau a pielii traumatizate-dermatita impetigo. Impetigo progreseaza rar la infectii sistemice, desi glomerulonefrita poststreptococica este o infectie rara asociata doar cu streptococii beta-hemolitici de grup A. While it may manifest as impetigo pyoderma intact skin may occur as a secondary infection of a preexisting skin disease or skin trauma, dermatitis impetigo. Impetigo rarely progresses to systemic infection, although glomerulonephritis associated poststreptococica is a rare infection only beta-hemolytic streptococci group A.
Impetigo nonbulos debuteaza cu o singura macula eritematoasa care se dezvolta rapid intro vezicula sau pustula si se rupe lasind o crusta galbena peste eroziune. Leziunile sunt asimptomatice. Ocazional pacientii raporteaza prurit sau durere . Nonbulos Impetigo begins with a single erythematous macule rapidly developing vesicle or pustule intro and breaks leaving a crust over the erosion yellow. The lesions are asymptomatic. Occasionally, patients report itching or pain. Infectia se extinde la zonele invecinate prin inoculare directa. The infection spreads to neighboring areas through direct inoculation. Impetigo bulos este caracterizat de aparitia unei vezicule care se transforma intro bula flasca superficiala sub 1 cm pe piele intacta. Bullous impetigo is characterized by the appearance of blisters that turn in a superficial flaccid bubble intro cm skin intact. Bula se rupe, se dezvolta o crusta care inlaturata lasa o baza rosie. Bulele intacte nu sunt prezente deoarece sunt foarte fragile. The bubble breaks, it develops a crust that removed leaving a red base. Intact bubbles are not present because they are very fragile. Leziunile pot fi localizate sau raspindite. Lesions may be localized or widespread. Frecvent afecteaza fata dar pot fi gasite oriunde pe corp. Affects the face but can often be found anywhere on the body.

Antibioticele sunt terapia standard. Antibiotics are standard therapy. Se alege un agent care sa acopere S. Choose an agent that covers S. Aureus si S. pyogenes . Aureus and S. pyogenes. se folosesc antibiotice topice pentru leziunile mici si putin numeroase, aplicate de doua ori pe zi pe zonele afctate timp de 7-10 zile. Topical antibiotics are used for small lesions and less numerous, applied twice a day for 7-10 days afctate areas. Debridarea gentila a crustelor lezionale, folosirea de sapunuri bactericide si spalarea hainelor sunt recomandate. Gentle debridement of crusts lesion, use of antibacterial soaps and washing clothes are recommended. O buna igiena cu detergent antibacterian, cum este clorhexidina poate preveni raspindirea impetigo si recurenta. Good hygiene with antibacterial detergent such as chlorhexidine can prevent the spread of impetigo and the appellant.

Impetigo se rezolva de obicei cu antibiotice topice sau orale . Impetigo usually resolve with topical or oral antibiotics. Rar apar complicatii serioase. Serious complications occur rarely. Vancomicina poate fi necesara pentru infectiile MRSA complicate care nu se amelioreaza cu antibioticele orale standard. Vancomycin may be required for complicated MRSA infections do not improve with standard oral antibiotics. Vindecarea spontana apare rar. Spontaneous healing rarely occurs. Netratate unele leziuni se pot rezolva spontan, in timp ce altele noi apar in alta parte. Untreated some lesions may resolve spontaneously, while new ones appear elsewhere. Rezolutia leziunilor apare in 7-10 zile de tratament. Resolution of lesions occur in 7-10 days of treatment. Daca leziunile nu s-au rezolvat in 10 zile trebuie prelevate culturi pentru a cauta organisme rezistente. If injuries were not resolved in 10 days should be taken to look for organisms resistant crops.

Patogenie Impetigo Impetigo pathogenesis

Aproximativ 30% din populatie este colonizata in narinele anterioare de S. About 30% of the population is colonized in the past nostrils S. Aureus . Aureus. Unii indivizi colonizati experimenteaza episoade recurente de impetigo pe nas sau buza. Some individuals experience recurrent episodes of impetigo colonized in the nose or lip. Bacteria se poate raspindi din nas pe pielea normala in 7-14 zile, iar impetigo apare dupa alte 14 zile. Bacteria can spread from the nose to normal skin within 7-14 days, and impetigo occurs after another 14 days. Aproximativ 10% dintre persoane sunt colonizate de S. aureus in perineu si mai frecvent in axile, faringe si miini. Approximately 10% of people are colonized by S. aureus in the perineum and frequently in the armpits, throat and hands. Persoanele care sunt purtatoare permanente servesc drept rezervor pentru a infecta alte persoane. Persons who are permanent carriers serve as a reservoir to infect other people. Cele mai multe persoane sanatoase sunt purtatori tranzitori ai S. Most healthy people are carriers of S. transient aureus ca parte a florei lor microbiene. aureus as part of their microbial flora. Pacientii cu dermatita atopica sau alte conditii inflamatorii ale pielii au mai frecvent pielea colonizata cu S. Patients with atopic dermatitis or other inflammatory skin conditions are more common skin colonized with S. aureus. aureus.

Organismul trece de la un individ la altul prin contact direct a miinilor, intrind prin leziuni ale pielii create de afectiuni cutanate (dermatita atopica, dermatofitoza , varicela, herpes simplex ), arsuri termice, leziuni chirurgicale, traume, leziuni de iradiere sau muscaturi de insecte. Body passes from one person to another through direct contact of hands, enter through skin lesions created by skin disorders (atopic dermatitis, dermatophyte , chickenpox, herpes simplex ), thermal burns, injuries, surgery, trauma, radiation injuries or insect bites . Imunosupresia prin medicamente (corticosteroizi sistemici, retinoizi orali, chimioterapie), afectiuni sistemice ( HIV , diabet ), abuz intravenos de droguri si dializa incurajeaza cresterea bacteriilor. Immunosuppression by drugs (systemic corticosteroids, oral retinoids, chemotherapy), systemic diseases ( HIV , diabetes ), intravenous drug abuse and dialysis encourages bacterial growth. O data ce infectia sa instalat, apar leziuni noi fara prezenta aparenta a afectiunilor pielii. Once infection set in, November lesions appear without the apparent presence of skin diseases.

Impetigo bulos. Bullous impetigo.
Forma buloasa este mai putin comuna fata de cea nonbuloasa. Bullous form is less common than the one nonbuloasa. Agentul cauzativ este S. Causative agent is S. aureus gram-pozitiv, coagulazo-pozitiv, de grup II. Acesta produce exotoxine extracelulare exfoliative A, B, D. Acestea determina pierderea adeziunii pielii in dermul superficial, cu aparitia de bule. gram-positive aureus, coagulase-positive, group II. It produces extracellular exfoliative exotoxin A, B, D. These cause loss of skin adhesion in the superficial dermis, with the emergence of bubbles. Fata de forma nonbuloasa leziunile apar pe piele intacta. Unlike the skin lesions appear as nonbuloasa intact.

Impetigo nonbulos. Impetigo nonbulos.
Astazi S. Today S. Aureus este principalul determinant al acestei forme. Aureus is the main determinant of this form. Peste 45% dintre cazuri sunt determinate de combinatii intre S. Over 45% of cases are caused by combinations of S. aureus si S. pyogenes. in tarile in dezvoltare streptococii beta-hemolitici de grup A sunt inca cea mai intilnita cauza. aureus and S. pyogenes. in developing countries beta-hemolytic streptococci group A are still the most commonly found cause.
Streptococii pot fi descoperiti in narile si faringele unor indivizi la 2-3 saptamini dupa ce s-au dezvoltat leziunile, desi acestia nu au simptome de faringita streptococica. Streptococci can be found in the nostrils and throat of individuals 2-3 weeks after lesions have developed, although they do not have symptoms of pharyngitis strep. Faringita si impetigo sunt determinate de tulpini diferite de streptococi. Pharyngitis and impetigo are caused by different strains of streptococci. Impetigo este datorat tulpinilor D iar faringita A, B, C. Impetigo is caused by strains D and pharyngitis A, B, C.

Cauze si factori de risc pentru impetigo Causes and Risk Factors for Impetigo

Impetigo este cauzat de o infectie bacteriana. Impetigo is caused by a bacterial infection.
Impetigo bulos poate fi determinat de S. Bullous impetigo may be caused by S. aureus de grup II tip 71. aureus group II, type 71. Tulpinile sunt de obicei rezistente la penicilina si chiar eritromicina. The strains are usually resistant to penicillin and erythromycin even. Sa observat si implicarea MRSA in 20% din cazuri. MRSA involvement was observed in 20% of cases.
Impetigo nonbulos este determinat de streptococii betahemolitici de grup A, S. Nonbulos Impetigo is caused by group A streptococci betahemolitici, S. Aureus sau un amestec din ambele organisme. Aureus or a mixture of both bodies. Streptococii grup B, C, G sunt cauze rare de impetigo nonbulos. Streptococci group B, C, G are rare cases of impetigo nonbulos. Streptococii B sunt asociati cu impetigo la nou-nascuti. B streptococci are associated with impetigo in neonates.