Tommy is a 5-year-old white boy who is brought to a family practice office with
ID: 55644 • Letter: T
Question
Tommy is a 5-year-old white boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved. He has been blowing his nose quite frequently and “sores” have developed around his nose. His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.” She is worried because the lesions are now also on his forearm. Tommy’s past medical and family histories are normal. He has been febrile but is otherwise asymptomatic. The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm. There is no regional lymphadenopathy. What is the likely name and cause of these lesions? Why have these lesions spread to Tommy’s arm? What is the likely bacterial culprit? How would you treat Tommy? Would it be okay for Tommy to return to school? Why or why not? Are there other things to consider for this case
Explanation / Answer
By seeing the above given symtoms the condition is known as Impetigo.Impetigo is a skin infrection caused by streptococcus pyrogenes or staphylococcus aureus.Streptococcus or staphylococcus bacteria can live harmlessly on or inside various parts of the body such as skin surface and nose.
It is also known as school sores as this is very common in school aged children.It is more common in warmer months.
Causes of impetigo:
Impetigo blisters and crusts are filled with bacteria,this makes it contagious particularly when it is weeping.The skin feels itchy and the child scratches and spreads the infection from their undernails to other parts of the body.As it is highly contagious so tommy should be kept at home rather than sending him to school until appropraite treatment was given.
Treatment of impetigo:
Suggestions for home care:
Lastly it is very much important for children to practice good personal hygiene.