Staphylococcal Staph Skin Infections

Cause Staphylococcus aureus bacteria can live harmlessly on skin surfaces, especially around the nose, mouth, genitals, and rectum. But when skin is punctured or broken, they can enter the wound and cause infections. Abscesses are collections of pus or fluid in tissues that result from an infection commonly involving staph bacteria. Specific types of abscesses include boils, folliculitis, and sties (see Eye Redness/Discharge in Chapter 29, "Signs and Symptoms"). Staph infections may also cause scalded skin syndrome, impetigo (see Impetigo in this chapter), and cellulitis (see Cellulitis in this chapter).

Symptoms Folliculitis is an infection of the hair follicles characterized by tiny, white-headed pimples at the base of the hair shafts, sometimes with a small red area around each pimple. Abscess of a hair follicle can lead to a boil, in which the infection spreads to the skin's oil glands or deeper tissue. The area may begin to itch or become mildly painful. Then it turns red and begins to swell over the infected area; the skin becomes very tender, and a white "head" may appear. The head may break open, and the boil may begin to drain pus, blood, or an amber-colored liquid. Scalded skin syndrome, a condition most often affecting newborns and children younger than five years, is a skin infection in which staph bacteria make a toxin that may affect the skin all over the body. The child has a fever, rash, and sometimes blisters. The rash often begins around the mouth, then spreads to the trunk, arms, and legs. As the blisters burst, the top layer of the skin peels off, and the skin surface becomes red and raw like a burn.

How It Spreads Fingers can carry staph infections from one area of the body to a wound or broken skin. Staph can spread through the air, on contaminated surfaces, and from person to person.

Incubation Period The incubation period is variable, depending on the skin injury and the age and health of the child.

How Long Symptoms Last Without treatment, folliculitis can either heal within a week or progress to the development of boils. Without treatment, boils may drain the pus they contain and heal in 10 to 20 days. Scalded skin syndrome may require treatment with intravenous antibiotics and management of the raw and vulnerable skin in a manner similar to that for burns.

When to Call Your Child's Doctor Call your child's doctor if your child has an area of red, irritated, or painful skin, especially if there are whitish or yellowish pus-filled bumps or "heads," or if your child has a fever. Call immediately if your infant develops blistered or peeling skin leaving raw, reddened areas. Also speak with the doctor if skin infections seem to be passing from one family member to another.

How the Diagnosis Is Made Folliculitis, a boil, or scalded skin syndrome is usually diagnosed by simply examining the skin. For severe infections, the doctor may take a fluid sample from the infected site and send it to the lab to identify the bacteria causing the infection.

Treatment Your child's doctor may cut and drain the boil and prescribe an antibiotic. For scalded skin syndrome, your child will be treated in a hospital and will usually be given intravenous antibiotics; the skin will be treated like a burn, and your child's body fluid balance will be monitored closely.

Home Treatment For folliculitis or a boil, remind your child not to touch the infected skin. Wash the skin with an antibacterial soap, apply an antibiotic ointment, and cover the skin with a clean dressing. To help relieve pain from a boil, use warm water soaks, a heating pad, or a hot water bottle applied to the skin for about 20 minutes three to four times a day. This also helps the boil drain the pus it contains sooner.

Prevention Wash hands regularly; keep child's skin clean with a daily bath or shower. Keep body areas that have been cut or injured clean and covered. To prevent the spread of an infection your child already has, use a towel only once when you clean an infected area, then wash it in hot water.

Complications With scalded skin syndrome, recovery usually occurs without complications, but excessive fluid loss, blood mineral imbalances, pneumonia, septicemia (blood infection), and cellulitis (see Cellulitis in this chapter) may occur.

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