CASE STUDY

Subjective: rash. 14 year old white male presents with many blisters filled with yellow or honey-colored fluid material on his right cheek. Some have been oozing and crusting over. Mom states her 12 year old daughter has also had a rash for over a month surrounding her nose/nostrils. Mom initially thought it was a mild case of acne and tried every acne product known to man to cure it, before finally decided it was time to take both of them to the doctor.


Objective: 14 yr old white male alert and oriented. No distress. Vital Signs are stable.
HEENT: unremarkable
H: RRR without murmurs
L: clear
Neuro: CN II-XII intact
Skin: multiple honey crusted lesions are noted on the right cheek. Some are reddened and appear to be drying up.

Assessment: Impetigo

Plan:
1. Wash (do not scrub) the skin several times a day, preferably with an antibacterial soap, to remove crusts and drainage.
2. Rx given for Bactroban to apply bid for 10 days
3. Patient education given. Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus (MRSA) is becoming a common cause. The skin normally has many types of bacteria on it, but intact skin is an effective barrier that keeps bacteria from entering and growing in the body. When there is a break in the skin, bacteria can enter the body and grow there, causing inflammation and infection. Breaks in the skin may occur with:

Animal bites

Human bites

Injury or trauma to the skin

Insect bites


Prevent the spread of infection.

•If you have impetigo, always use a clean washcloth and towel each time.

•Do not share towels, clothing, razors, and and other personal care products with other family members.

•Wash your hands thoroughly after touching the skin lesions.