Diagnosis and Pathophysiology of Impetigo - Essay Example

Case Study: Diagnosis and Pathophysiology of Impetigo Case Study: Diagnosis and Pathophysiology ofImpetigo Young children have an immune system that is compromised quickly by allergic reactions and other related illnesses. A four-year child participates in activities that involve skin-to-skin contact, and that could be a possible cause for infections. Environmental conditions could also lead to spread of bacteria on the skin. Additionally, poor hygiene conditions may also lead to skin-based infections in children. Skin infections manifest themselves in different ways, and that allows physicians or dermatologists to make relevant diagnosis for the infection. One of the common manifestations of skin infestation is crusted lesions. Crusted lesions may start as a small vesicle because of infectious agents. A 4-year old child who has developed crusted lesions within a small erythematous macular area could be diagnosed with three different possible infections on the face. Possible diagnoses that could be presented as crusted lesions include bullous impetigo, nonbullous impetigo, and ecthyma. The differential diagnosis of bullous impetigo, nonbullous impetigo, and ecthyma will be put into perspective. The paper will also outline the pathophysiology of the three differential diagnosis identified as possible presentation of crusted lesions. Differential Diagnoses Bullous impetigo The crust lesions of bullous impetigo start with fluid-filled appearances on the face of a child. The fluid-filled appearances are called bullae. The blisters spread quickly on the face within several days and dry up to leave visible scars. A child may complain of pains on the scars left by the crusts. A young child of between 4-6 years may be diagnosed with bullous impetigo after showing symptoms such as fever and swollen glands (Fleisher & Ludwig, 2010). Doctors are careful with the swab diagnosis because the symptoms could indicate other disease infections other than bullous impetigo. The crusts left should not be touched or scratched to avoid extra pain and itchiness. Non-bullous impetigo Non-bullous impetigo manifests symptoms close to bullous impetigo. However, instead of fluid-filled appearances on the face, non-bullous appears in the form of red sores. The areas in the region of the nose and the mouth are affected by the red sores, but the infections could also spread quickly to limbs and other areas of the face. The itchiness of the red sores sets in as soon the infection spreads on face and other areas such as limbs. Young children show hard crust lesions that could be scratched. The redness of the sores disappears within a period of 4 days or a few weeks in extreme cases of non-bullous impetigo infections (Fleisher & Ludwig, 2010). Ecthyma Ecthyma is a deeper appearance of impetigo that has more severe symptoms than bullous and nonbullous impetigo. The infections extend to the dermis of the skin resulting into ulcerative pyoderma. Ecthyma is caused by poor hygiene that predisposes young children to severe skin infections. Additionally, physicians could use hot and humid climates to tell crust lesions that are caused by ecthyma infections. Young children who are not treated for impetigo are susceptible to ecthyma infections. Any delay in diagnosis and treatment of ecthyma may result in death when venous or arterial muscles are infected. Pathophysiology Bullous Impetigo The fluid-filled vesicles rupture and give rise to crusts with honey-like coloration. The vesicles also enlarge from the bullae that are formed by rupture. Bullae burst and expose the bigger bases of the skin on the face of children. The blisters come in 1-2cm in measurement and spread quickly throughout the face within several days. S. aureus bacteria that give rise to the bullae cause bullous impetigo. The bullae burst to form the honey-colored crusts. S. aureus prospers where there are cellular and extracellular products such as exotoxins. Young children with preexisting injuries are likely to feature severe bursts and ruptures (Fleisher & Ludwig, 2010). Non-bullous impetigo The pathophysiology of non-bullous impetigo is more severe than bullous impetigo. The functional changes that arise from Non-bullous impetigo occur on the face and other extremities. The ruptures occur from S. aureus may appear in 2cm patches in measurement before spreading to other parts of the skins. The red sores around the nose and mouth burst and form crusts that appear as cornflakes. Children may show fever and swollen glands but in rare cases due to the inflammation caused by the infection. S.pyogenes is also a possible cause of nonbullous impetigo that causes tiny blisters on extremities. The blisters rupture with time and leave red wet patches and occasional weeps. Ecthyma The functional changes that occur because of Pseudomonas aeruginosa bacterium infection are severe than normal impetigo (Fleisher & Ludwig, 2010). The vesicles are hemorrhagic after bursting, and they may spread into ulcers with tender erythematous patches on the skin. The infection is rare, but it is prevalent in immune-compromised young children. The cutaneous lesions are life threatening if they spread deeper in the dermis. Other invasive complications such as cellulitis and lymphangitis may develop if the streptococcal skin infections spread deeper in the skin. Impetigo and Other Diseases Impetigo differentiates itself from other skin diseases that curse with crusty lesions. Some of the diseases that show close manifestations include Varicella and Molluscum contagiosum. Varicella Varicella zoster virus (VZV) causes Varicella when there is contacted with contagious components such as soil. The disease occurs in areas with temperate climates among children with ten years or less. The disease is more severe in adulthood than when it occurs in kids. The functional changes that occur because of VZV infections start with itchiness and vesicular rash. The changes occur on the scalps and faces of young children and adults but in varying degrees. The rushes spread quickly from the face to trunk and other body extremities. Immuno-compromised individuals may be infected to the point of death (Porth & Porth, 2011). Molluscum contagiosum Molluscum contagiosum (MC) occurs due to the viral infection on the skin. The disease starts out as raised papules on the skin that could be itchy but without pain. The spots look unpleasant and could stay for months without treatment. Scarring and mild damages may occur on the skin because of infection. Bacteria may infect open spots and increase the level of MC infection. However, patients can use antibiotics to remove the bacterial infections (Porth & Porth, 2011). References Fleisher, G., & Ludwig, S. (2010). Textbook of pediatric emergency medicine. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. Porth, C., & Porth, C. (2011). Essentials of pathophysiology. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. Read More