Impetigo From Hand Foot And Mouth

Impetigo: A Complication of Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is a common viral infection that primarily affects young children. While it usually resolves on its own within a week or two, sometimes it can lead to secondary bacterial infections, one of the most common being impetigo. This article delves into the connection between HFMD and impetigo, exploring the causes, symptoms, diagnosis, treatment, and prevention of this potentially problematic complication.

Understanding Hand, Foot, and Mouth Disease (HFMD)

HFMD is typically caused by Coxsackievirus A16 or Enterovirus 71. It's highly contagious, spreading through direct contact with nasal secretions, saliva, blister fluid, or stool from an infected person. The incubation period is usually 3-6 days.

Symptoms of HFMD

The hallmark symptoms of HFMD include:

• Fever: Often the first sign, usually mild to moderate.
• Sore throat: Can be accompanied by difficulty swallowing.
• Mouth sores: Small, painful ulcers develop inside the mouth, often on the tongue, gums, and inner cheeks. These can be quite distressing for young children.
• Skin rash: A characteristic rash appears on the hands, feet, and sometimes the buttocks. It manifests as small, flat, red spots that may develop into blisters.

The Link Between HFMD and Impetigo

While HFMD itself is a viral infection, impetigo is a bacterial skin infection. The connection arises because the broken skin caused by the blisters and sores of HFMD creates an entry point for bacteria, most commonly Staphylococcus aureus or Streptococcus pyogenes. These bacteria thrive in the moist environment created by the HFMD lesions, leading to a secondary bacterial infection.

What is Impetigo?

Impetigo is a highly contagious bacterial skin infection that primarily affects children. It's characterized by sores that develop honey-colored crusts. There are two main types:

Non-bullous Impetigo

This is the most common type, starting with small blisters or sores that quickly rupture, leaving behind a characteristic honey-colored crust. These sores are typically itchy and may spread easily by scratching.

Bullous Impetigo

This type features larger, fluid-filled blisters that are less likely to rupture initially. These blisters may become larger and form flaccid bullae (fluid-filled sacs). Bullous impetigo is often associated with Staphylococcus aureus.

Recognizing Impetigo as a Complication of HFMD

Identifying impetigo as a complication of HFMD requires careful observation. While HFMD sores are initially small and generally heal without scarring, impetigo sores have distinct features:

• Honey-colored crusts: This is the most striking feature of impetigo.
• Rapid spreading: Impetigo sores tend to spread more quickly than HFMD lesions.
• Increased inflammation: The area surrounding the impetigo sores may show more significant redness and inflammation compared to HFMD lesions.
• Pain and discomfort: While HFMD sores can be painful, impetigo sores often cause more intense pain and discomfort.
• Fever (potentially): Impetigo may present with a fever, although this isn't always the case.

Diagnosing Impetigo

Diagnosis of impetigo is typically made by a doctor based on a physical examination. The characteristic honey-colored crusts and the history of HFMD strongly suggest impetigo. In some cases, a swab may be taken from the lesion to confirm the bacterial infection and identify the specific bacteria involved.

Treating Impetigo

Treatment for impetigo usually involves topical or oral antibiotics. The choice of antibiotic depends on the severity of the infection and the age of the child.

Topical Antibiotics

For mild cases of impetigo, a topical antibiotic ointment, such as mupirocin, is often prescribed. This should be applied directly to the affected areas several times a day.

Oral Antibiotics

More severe cases of impetigo, or those that don't respond to topical treatment, may require oral antibiotics. Amoxicillin, cephalexin, or dicloxacillin are commonly used. The doctor will determine the appropriate antibiotic and dosage based on the child's age and overall health.

Managing Symptoms

In addition to antibiotics, managing symptoms is crucial:

• Keep the affected area clean: Gently wash the affected area with soap and water several times a day.
• Avoid scratching: Scratching can spread the infection and lead to scarring.
• Keep the area covered: Covering the affected area with a clean bandage can help prevent the spread of infection and protect the sores.
• Pain relief: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain and fever.

Preventing Impetigo After HFMD

Preventing impetigo after HFMD is primarily about good hygiene practices:

• Frequent handwashing: Thorough handwashing with soap and water is crucial to prevent the spread of bacteria.
• Avoid scratching: Teach children to avoid scratching the HFMD sores to minimize the risk of breaking the skin and allowing bacteria to enter.
• Keep fingernails short: Short fingernails reduce the risk of scratching and spreading the infection.
• Separate towels and clothing: Use separate towels and clothing for the infected child to prevent the spread of bacteria.
• Disinfect surfaces: Regularly disinfect frequently touched surfaces, such as doorknobs, toys, and countertops.

When to Seek Medical Attention

It's essential to seek medical attention if:

• Impetigo doesn't improve with treatment: If the infection doesn't show improvement within a few days of starting treatment, consult a doctor.
• The infection spreads rapidly: Rapid spreading of impetigo is a sign that the infection is severe and requires immediate medical attention.
• The child develops a high fever: A high fever indicates a more serious infection and warrants immediate medical evaluation.
• The child shows signs of dehydration: Dehydration can be a serious complication of impetigo, particularly in young children.
• The impetigo is near the eyes: Impetigo near the eyes poses a risk to vision and requires prompt medical attention.

Conclusion

Impetigo, while a common bacterial skin infection, can be a significant complication of HFMD. Early recognition of impetigo and prompt treatment with antibiotics are crucial for preventing complications and ensuring a speedy recovery. Good hygiene practices are vital in preventing both HFMD and impetigo. Remember, this information is for educational purposes and shouldn't replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment of any medical condition. Early intervention and diligent hygiene practices are key to managing this potential complication effectively.