Streptococcal Skin Infections
Group A -hemolytic streptococci are not normal skin flora. Streptococcal skin infections result from colonization of normal skin by contact with other infected individuals or by preceding streptococcal respiratory infection. Clinical Findings SYMPTOMS AND SIGNS Impetigo is a focal, vesicular, pustular lesion with a thick, amber-colored crust with a "stuck-on" appearance. Erysipelas is a painful superficial cellulitis that frequently involves the face. It is well demarcated from the surrounding normal skin. It affects skin with impaired lymphatic drainage, such as edematous lower extremities or wounds. LABORATORY FINDINGS Cultures obtained from a wound or pustule are likely to grow group A streptococci. Blood cultures are occasionally positive. Treatment Parenteral antibiotics are indicated for patients with facial erysipelas or evidence of systemic infection. Penicillin, 2 million units intravenously every 4 hours, is the drug of choice. However, staphylococci infections may ...