Neonatal impetigo

Introduction to neonatal impetigo Neonatal impetigo is common in neonates, mainly caused by Staphylococcus aureus infection, an acute infectious suppurative skin disease characterized by skin bullae. It has a sharp onset and is highly contagious and must be given special attention. Mainly Staphylococcus aureus infection, the most common type of Staphylococcus aureus group II 71, followed by 80/81 type. basic knowledge The proportion of illness: 0.001% Susceptible people: infants and young children Mode of infection: contact infection Complications: neonatal fever, diarrhea, anemia, sepsis, pneumonia, meningitis

Neonatal impetigo cause

Causes:

Unsound skin function (30%):

The pathogen of neonatal impetigo is the same as that of other age groups of impetigo, but due to the delicate skin and impaired function of the newborn, it forms a unique clinical manifestation of this disease.

Pathogenic bacteria infection (35%):

Infected by coagulase-positive Staphylococcus aureus and/or hemolytic streptococcus, it is particularly sensitive to bacteria because it is first exposed to bacteria.

Other factors (20%):

Malnutrition, hot and humid climate, wrapped with plastic cloth and other factors that promote skin impregnation, etc., also play a certain role in causing this disease.

Pathogenesis:

1. Weak skin barrier The newborn's skin is thin and tender, the secretory function is not fully developed, and the resident flora of epidermal parasitism has not yet fully formed. Therefore, local immune function is low and easy to be infected. After infection, it is easy to spread by inoculation. The whole body, or mutual infection, causes a prevalence in the neonatal room.

2. Weak humoral immunity The IgG of neonatal serum is lower than normal, and the maternal IgG through the placenta also lacks natural immunity. Therefore, it is difficult for children to resist bacterial infection and reinfection, especially in premature infants and malnourished newborns. child.

3. Various toxins of Staphylococcus aureus, in which the epidermal exfoliation toxin is the first, it can loosen the connection between epidermal cells, making other toxins more invasive, and some toxins can cause chills, fever, and even after entering the blood circulation. The occurrence of S. aureus scalded skin syndrome (SSSS).

4. Abnormal allergies

(1) Type II allergic reaction: From the children with impetigo secondary to acute nephritis, the isolated pathogenic strain and the glomerular basement membrane have a common antigen, and the corresponding antibody and glomerular basement membrane produced by the body Binding causes type II allergies to cause immune damage to the kidneys.

(2) Type III allergic reaction: The antigen-antibody complex formed by the M protein of the pathogenic strain is deposited on the glomerular basement membrane to cause immune damage, which is a blister under the cornea. The blister contains a large number of neutrophils and cocci. Fibrin, the formation of sacral spine cell sponge, or a small number of acantholytic cells, neutrophils infiltrated into the spine cells, vascular expansion in the upper part of the dermis, hyperemia, moderate neutrophils and lymphocytic infiltration.

Neonatal impetigo prevention

1. In the baby room, strengthen the examination of the baby whether there is impetigo skin lesions, once found that the baby with the disease, should be promptly isolated treatment.

2. In the baby room, strengthen the inspection staff, once found to have carriers, should be immediately removed and treated to eliminate the source of infection.

3. Dispose of the child's clothes, diapers, toys, bedding, dressing utensils, dressings, etc., and close the baby room if necessary, and then open it after re-sterilization.

Neonatal impetigo complications Complications neonatal fever diarrhea anemia sepsis pneumonia meningitis

Severe cases may have mucosal involvement, and bloated or systemic symptoms such as fever, diarrhea, weakness, weight loss, anemia, etc., some complicated with sepsis, pneumonia or meningitis.

Neonatal impetigo symptoms Common symptoms Pustular redness newborn skin thin spot rash fever diarrhea

More than 4 to 10 days after birth, in the face, trunk and limbs suddenly appeared bullae, from peas to walnuts, the size varies, the blister fluid is pale yellow and clear, after 1 to 2 days, part of the blister fluid Turbidity, the bottom of the blister has a semi-monthly empyema phenomenon, then the pus gradually increases, but the entire bullae is not fully purulent, so the characteristics of water pustules, no redness around the blisters, thin walls, easy to rupture, reddish after the break The moist smashed surface is covered with a thin yellow sputum. The suede peels off and temporarily leaves a brown rash. After disappearing, there is no trace. The lesion develops rapidly. In a few hours, 1 to 2 days will affect most of the leather surface, and the mucous membrane may also Damaged.

There is no systemic symptoms at first, and there may be fever and diarrhea in the future.

Examination of neonatal impetigo

Laboratory examination

Peripheral blood has increased blood cells and neutrophils, and meningitis, cerebrospinal fluid examination has a corresponding change in white blood cell count, and patients with sepsis, blood culture positive.

2. Other auxiliary inspections

Chest radiographs of patients with pneumonia can be seen in scattered patchy shadows.

Chest X-ray examination is often used to examine diseases of the thorax (including ribs, thoracic vertebrae, soft tissues, etc.), chest, lung tissue, mediastinum, heart, etc. Such as pneumonia, tumors, fractures, pneumothorax, pulmonary heart disease, heart disease.

Diagnosis and diagnosis of neonatal impetigo

According to the characteristics of pustules, parts, contact infection, rapid spread, etc., easier to diagnose.

Differential diagnosis

1. The basic damage of chickenpox is scattered, the mung bean to the big bean blister distributed in the center of the heart, surrounded by blush, some blisters may have umbilical concavity, purulent and crusting phenomenon is very light, can invade the mucous membrane, some children have fever and other systemic symptoms .

2. Acute systemic rash pustulosis is a transient aseptic pustulosis. The children have a history of medication or infection. The basic damage is dense superficial pustules on the basis of systemic erythema. , appeared in batches, late exfoliative dermatitis performance, may have fever 38 ~ 39 ° C, but the course of disease is short, the condition is self-limiting, can be cured naturally after symptomatic treatment.

The disease should be differentiated from bullous epidermolysis and neonatal exfoliative dermatitis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.