My daughter has blisters that have bust and have begun to ooze and create yellow crust. Well right now it is red and it look like sores. Well the doctors say that it might be Impetigo and it is not MR-SA. They check her for that. She has been on cephalexin oral medication to get rid of it. She has been taking it for 4 days and it is still spreading. Has anyone had this? Did it spread when you was still on medication? How to get rid of it? How to stop the spreading? Now my daughter is 2 months old and it is on her head. Has anyone use this medication and when it begun to get better? How do you know when it get better? Also if it is not impetigo, what is it?
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Hello,
I’m afraid this answer will have to go into some medical jargon
In my opinion, almost certainly your 2-month old daughter has "bullous impetigo," pronounced’ BULL” -us. In this type of impetigo, – which is the most common type of impetigo in infants and children, – the blisters are the first sign of the disease. In medical jargon, these blisters are called "bullae," pronounced BULL” -eee, (the plural of ‘bulla’), – - but this type might just as well have been called "blister-y impetigo."
This would be as opposed to, the blisters having *first* been caused by something else, – like insect bites, for example, – - and the germs then exploiting a raw skin surface, to cause a secondary infection there. This is the more usual type of impetigo in adults… first the adult, for some reason, gets a raw skin surface, – - like after a burn or after a graze of the skin, – - and the impetigo germ then "jumps in" to colonize it secondarily.
Bullous impetigo is caused by the germ "Staphylococcus aureus," and is usually a "pure" infection, (un-contaminated by other germs). The scientific naming for germs, works in exactly the same way as the scientific naming of the rest of the animal and plant kingdoms. So, like "Homo sapiens" is the scientific description of modern man, "Staphylococcus aureus" is the scientific name of this particular germ or bacterium.
Without wanting to labour the point, "Homo" and "Staphylococcus (usually abbreviated to "Staph")" are the Generic names, – - and "sapiens" (= "wise"), and "aureus" (= "gold colored pus- producing") are the species names.
The Staph. aureus which produces Bullous Impetigo, is usually of a particular sub- species: the full name would then be "Staphylococcus aureus Phage Group 2." Sorry about this. The face and head are common ‘attack’ sites in infants, for bullous impetigo.
You would think, that an "MRSA" type of Staphylococcus, was a well-defined type, wouldn’t you? However, this abbreviation only means "Methicillin- Resistant Staphylococcus aureus," and it only refers to the fact that these particular Staphs are resistant to Penicillin- and Enhanced-Penicillin- antibiotics. Broadly speaking, resistant to all Penicillins.
Or to put it another way, – - immediately after Alexander Fleming discovered Penicillin about 1940, there were only Penicillin-SENSITIVE Staphylococci. But since then, the Staphs collectively have been developing resistance to more and more of the popularly-used antibiotics.
There is no real connection between Methicillin-resistance, and "aggressiveness" in the Staphs, – - only that those germs don’t respond to the Penicillins as a treatment.
So "might be Impetigo and it is not MR-SA." is confusing, since it mixes two different ideas, – - it is almost certainly Bullous Impetigo caused by a Phage-Type 2 Staph, in my opinion, – - but just not a Staph that is sensitive to Penicillin.
Cephalexin is a different antibiotic from Penicillin. The oral form is fine so long as your infant is well, and can take the medicine without vomiting it back up?
Occasionally serious "deep" infections like Staphylococcal- bone infections, joint infections, and lung infections, can develop by "deep" spread of an apparently innocuous, superficial skin infection in infants, – - the child then becomes ill, and at least needs the Cephalexin (or other antibiotic) by injection in hospital.
In my opinion, the infant should also be having an antibiotic cream on the sore surfaces. The fact that skin cream constituents are not usually absorbed into the blood, means that creams can contain antibiotics which are much too toxic to be given by mouth, – - like Bactroban cream, Fucidin cream, Gentamicin ointment, or Polymixin cream, for example.
The skin infection should stop spreading and start to subside. The child should remain well in herself throughout.
There may be a reservoir of Staph germs inside the nostrils in children, and either a nose-swab test, or antibiotic cream to be put up into the nostrils, is often advised.
In my opinion, it is not a good sign that the infection is still red and inflamed, and still spreading. The infant needs a change of oral antibiotic and a change of skin cream, in my opinion.
Cleaning the skin with a dilute anti-bacterial wash, – e.g. Dettol, Hibitane, – is a good idea. Crusts should be removed because they block the penetration of anti-bacterial creams.
I hope this is of some help, I think I have addressed all your points. Maybe gone a bit beyond them, in fact, apols.
Best wishes,
Belliger (retired uk gp)
belliger@nym.hush.com