What Is Bullous Impetigo?

Bullous impetigo is a disease mainly caused by. This type is common in newborns, also known as impetigoneonatorum. If not treated in time, it can be life-threatening due to sepsis or toxemia.

Bullous impetigo

Bullous impetigo is a disease mainly caused by. This type is common in newborns, also known as impetigoneonatorum. If it is not treated in time, it can be caused by

Occurred in infants 4 to 10 days after birth. Sudden bullae occur on the face, trunk, and extremities, and the blister fluid begins to clarify. Afterwards, the pus is cloudy and purulent, surrounded by red halo. The blister wall is thin and easy to rupture, and the bright red moist erosive surface can be exposed after breaking. The lesions develop rapidly, and most of the skin can be affected within a few hours or 1 to 2 days, and the mucosa can also be affected. There are no systemic symptoms at first, and then there may be fever or low fever, often with green foam, and some may die of sepsis, pneumonia, nephritis or meningitis.

The pathogenic bacteria of this disease are the same as those of impetigo patients in other age groups, but due to the characteristics of delicate skin and imperfections in the newborn, the clinical manifestations of this disease are unique. Furthermore, because newborns are exposed to bacteria for the first time, they are particularly sensitive to bacteria and may be an important factor. In addition, malnutrition, hot and humid climate, wrapping with plastic cloth, and other factors that promote the skin to be easily impregnated, also play a role in causing the disease. The source of infection mainly comes from medical personnel or mothers. During the epidemic, staphylococci can be isolated not only in medical personnel, but also in clothing, quilts, air and dust.

It is a bullae under the stratum corneum in the epidermis. The vesicle contains many neutrophils and cocci. The spinous layer of the blister bottom has sponge formation and many neutrophils infiltration. The upper dermis is a non-specific inflammatory change.

(1) Systemic treatment, early effective antibiotics such as penicillin, erythromycin or cephalosporins, and supportive therapy, including blood transfusion or intramuscular injection of gamma globulin. Systemic therapy is based on the patient's skin lesions and systemic symptoms, as appropriate, sulfa drugs or antibiotics, such as penicillin G (0.812.4 million U / d, intramuscular injection, children 25,000 U.K./kg, daily 2 to 4 times), neopenicillin II, ampicillin sodium (ampicillin sodium), cephalexin and so on. People who are allergic to penicillin can give erythromycin orally (0.25 to 0.5 g, 3 to 4 times a day, children 25 to 50 my / kg daily 3 to 4 times) or lincomycin intramuscularly (0.6 g, Once every 8 hours, pediatric daily 20-40mg / kg, divided into 2 times), or corresponding antibiotics according to drug sensitivity test. For severe neonatal impetigo, large doses of highly sensitive antibiotics should be given, and supportive therapy should be strengthened, including plasma (or whole blood) transfusion or intramuscular gamma globulin injection.

(2) For local treatment, pay attention to protect the wound surface and avoid friction, and apply mupirocin ointment or 0.5% to 1% neomycin emulsion. Topical therapies are based on the principles of sterilization, anti-inflammatory, astringent, and dryness. If the pustules are intact, 5% sulphur and 1% camphor calamine lotion can be exuded, multiple times a day. If the pustules are large, remove the pus with a sterilized syringe and dry it with sterilized cotton before rubbing the lotion. If the pustules have been ulcerated and crusted, it is advisable to use 0.1% ethacridine lactate solution or 0.5% neomycin solution or 1: 5000 to 10,000 potassium permanganate solution to wash or wet compress. Remove the skin of the salamander, and then exhale 0.5% neomycin 3% bran oil paste or 0.5% neomycin ointment. Mupirocin ointment recently used for impetigo has the characteristics of rapid onset and high efficacy.

(1) No medical staff or family members with purulent skin disease should contact the newborn.

(2) Pay attention to the hygiene of the baby, and the diapers should be clean.