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PubMedDate not supplied

The head louse in Sierra Leone: an epidemiological study among school children, in the Njala area.

A survey of five primary schools in the Njala area, Sierra Leone showed that Pediculus humanus capitis infestation is wide-spread. The overall prevalence was 6.8% among 1007 school children examined. Infestation rates varied between schools from 1.4% to 14.6% and the prevalence of infestation increased with age, from 3.1% among class I children to 10.2% among class IV and decreased to 4.9% among class VI children. Females had a higher infestation rate (8.3%) than their male counterparts (5.4%). The infestation rate was higher' in children whose fathers were Farmers (9.4%) followed by Traders (7.8%), Artisans (6.5%) and Professionals who had the lowest infestation rate of (5.8%). Sharing of beds, beddings and combs had a significant effect (P < 0.01) on the rate of infestation. The infestation was light, therefore, impetigo was minimal. Overcrowding at home is the main factor facilitating the transmission of the infestation from one head to another among these children.

Child↗
PubMed1992

Streptococcal skin diseases in children.

Infections with streptococcal bacteria continue to be a common problem in children. They can produce cutaneous manifestations via three main mechanisms: (1) direct infection of the skin; (2) toxin-mediated disease; and (3) immunologically mediated disease. This review updates a variety of streptococcal diseases involving the skin. The changing bacteriology of impetigo is addressed, as well as the resurgence of rheumatic fever. A new manifestation of invasive streptococcal infection, termed streptococcal toxic shocklike syndrome, is also presented. Many changes in the epidemiology of streptococcal infections during the 1980s can be traced to the reemergence of more virulent strains of the organism. The impact of this natural occurrence is discussed. Therapeutic recommendations are presented for each disease, and the value of rapid streptococcal tests is reviewed.

Blister↗
PubMedDate not supplied

Prevalence of skin infections in sheltered homeless.

In an attempt to determine the prevalence of various skin infections in the homeless population in Marseilles, France, we undertook a case control study. Cases were recruited among institutionalized homeless subjects during two snapshot investigations conducted in January 2002 and 2003 respectively. The control subjects were recruited from among those who presented at a clinic for pre-travel advice. We recruited 498 cases and 200 control subjects. Compared to control subjects, a significantly higher proportion of cases had skin diseases (38% versus 0.5%; p < 0.0001). Pruritus, body-lice infestation, scratching lesions, folliculitis, tinea pedis, scabies and impetigo (ecthyma) were strongly significantly associated with homelessness. The higher prevalence of skin infections in the homeless people mainly results from the body-louse infestation, scabies, bacterial super-infection of skin surfaces that have been breached by frequent scratching and tinea pedis due to poor foot hygiene.

Adult↗
PubMedDate not supplied

Treatment of uncomplicated skin and skin infections in the pediatric and adolescent patient populations.

Before 1980, superficial pyodermas in the US were caused primarily by streptococci. Studies conducted in Miami show that during the early 1980s, the predominant pathogen associated with impetigo in pediatric patients shifted from Streptococcus pyogenes to Staphylococcus aureus. Subsequent reports revealed a trend of increasing resistance of S. aureus to penicillins. By regular monitoring of local sensitivity patterns physicians are more likely to select the appropriate antibiotic. The current recommendation for the treatment of pediatric skin disease is cephalosporins due to their low likelihood of resistance by S. aureus.

Adolescent↗
PubMedDate not supplied

Cefprozil versus cefaclor in the treatment of mild to moderate skin and skin-structure infections. The Cefprozil Multicenter Study Group.

In a multicenter study, 598 patients with skin or skin-structure infections were randomly assigned to receive 500 mg of cefprozil once daily (or 20 mg/kg once daily) or 250 mg of cefaclor three times daily (or 20 mg/kg daily in three equal doses) for 5 to 10 days. Treatment was evaluated in 212 cefprozil-treated patients and in 210 cefaclor-treated patients. The patients were aged 2 to 99 years (mean, 28 years) and their primary diagnoses were impetigo (in 99 patients), pyoderma (in 98), superficial abscess (in 70), and cellulitis (in 64). A satisfactory clinical response was found in 93% of the cefprozil-treated patients and in 92% of the cefaclor-treated patients, the pathogens were eradicated in 91% and 89%, and overall treatment was rated effective in 87% of both groups. Adverse clinical events were reported by 5% of the patients in both groups; one cefprozil-treated patient and three cefaclor-treated patients withdrew from treatment because of adverse events. It is concluded that cefprozil administered once daily is as effective and safe as cefaclor administered three times daily in the treatment of mild to moderate skin and skin-structure infections.

Abscess↗
PubMed1991

Lindane toxicity in an infant.

A four-month-old infant with severe impetigo who had prolonged daily applications of lindane presented with two seizure episodes. His blood lindane level was 1.27 ppm. Caution should be exercised when using lindane in infants and children. Proper instruction and close supervision are essential.

Hexachlorocyclohexane↗
PubMed1990

[Clinical evaluation of cefdinir in pediatric field].

We studied the clinical efficacy of cefdinir (CFDN), a new oral cephalosporin, in 18 children with ages 2 years and 4 months to 11 years and 4 months with pediatric infections. The diagnoses consisted of respiratory tract infections in 15 cases, impetigo in 2 and balanoposthitis in 1. Clinical efficacies were excellent in 11 patients and good in 7, with an efficacy rate of 100%. Bacteriologically, 9 (64.3%) of the 14 strains of clinical isolates were eradicated. No side effects nor abnormal laboratory findings were observed. We have concluded that CFDN is a useful antibiotic for the treatment of mild to moderate pediatric infections.

Administration, Oral↗
PubMed1989

[Clinical experience with clarithromycin in the pediatric field].

Clarithromycin (TE-031, A-56268) was orally administered to 20 children with the following acute bacterial infections; 1 case of acute pharyngitis, 3 cases of acute tonsillitis, 11 cases of acute bronchitis, 1 case of exacerbation of chronic bronchitis, 1 case of acute bronchopneumonia, 2 cases of Mycoplasma pneumonia and 1 case of impetigo. Clinical effectiveness was obtained in 15 out of the 20 cases (75.0%). No clinical side effects and laboratory abnormalities were observed. The above results suggest that TE-031 is a useful antibiotics for treating pediatric patients with various bacterial infections.

Administration, Oral↗
PubMed1989

[Clinical study of cefpodoxime proxetil dry syrup for skin and soft tissue infections in the field of pediatrics].

Concurrently with administering a newly developed cephem derivative antibiotic (CEP), cefpodoxime proxetil (CPDX-PR, CS-807) dry syrup, to children with skin and soft tissue infections, activities of 7 drugs against a group of microorganisms were tested. The drugs tested included 4 drugs of the cephem group, R-3746, a Na-salt form of CPDX, cefaclor (CCL), cephalexin (CEX) and cefadroxil (CDX), and 3 drugs of the penicillin group, ampicillin (ABPC), methicillin (DMPPC) and cloxacillin (MCIPC). The bacterial strains tested were 71 strains of Staphylococcus aureus and 1 strain of Streptococcus pyogenes, all isolated from the above cases of pediatric infections. Inoculum sizes used in these tests were 10(6) and 10(8) cfu/ml. Ages of children in those cases to which the drug was administered ranged from 2 months to 15 years. A total of 66 cases were treated, including 60 cases of impetigo, 5 cases of subcutaneous abscess and 1 case of phlegmon. The drug was administered for an average of 6 days with a daily average dose level of 9.4 mg/kg divided into 3 doses except 1 case where a twice daily dose regimen was used. Clinical and bacteriological effects were examined, and the occurrence of adverse reactions and abnormal laboratory test results were recorded. The results of these tests are summarized below. 1. The activity test for R-3746 (Na-salt of CPDX) against 71 strains of S. aureus performed at an inoculum level of 10(8) cfu/ml showed 2 peaks of MIC values, one in a range of 1.56 to 6.25 micrograms/ml and the other higher than 100 micrograms/ml. The most prevalent MIC value was 3.13 micrograms/ml with MIC against 51 strains or 71.8% of the strains tested showing this value, and MIC values of 25 micrograms/ml or higher were obtained for 13 strains or 18.3% of the strains tested. The MIC80 was 6.25 micrograms/ml. Thus, R-3746 showed an antibacterial activity slightly weaker than MCIPC and DMPPC but similar to CCL, CEX and CDX. MIC values obtained at an inoculum level of 10(6) cfu/ml also had 2 peaks, one in a range of 1.56 to 3.13 micrograms/ml and the other higher than 25 micrograms/ml. Strains against which R-3746 had the MIC value of 3.13 micrograms/ml were the most numerous with 47 strains or 66.2%, and strains against which the MIC value of higher than 25 micrograms/ml was obtained were next with 13 strains or 18.3%.(ABSTRACT TRUNCATED AT 400 WORDS)

Abscess↗
PubMed1979

Postinjection infection-two unusual cases.

Two unusual forms of infection after local anesthesia have been presented. The first, a case of cellulitis, was thought initially to be a hypersensitivity reaction. The second, a case of impetigo, might prove difficult to diagnose because of its relative rarity.

Anesthesia, Dental↗
PubMed1987

Classification of diaper dermatitis: an overview.

Several types of diaper dermatitis are discussed: generic diaper dermatitis is most common and involves a simple erythema and mild scaling of the gluteal crease, buttocks, thighs, and lower abdomen. Candidal diaper dermatitis involves clinically significant infection with Candida albicans and presents as a sharply marginated area of erythema with significant involvement of the anterior thighs, genital creases, abdomen, and genitalia. Noduloulcerative diaper dermatitis may develop in a small percentage of patients who have chronic diaper dermatitis, as large, raised erosions with rolled margins. The lesions are most noticeable on the prominent body parts-genitalia, abdomen, thighs, and buttocks. Infantile seborrheic dermatitis involves a distinctive pattern of inflammation that usually begins beneath the diaper as a sharply marginated area of erythema with satellite lesions. Within 1-2 weeks, lesions develop on the scalp, cheeks, arms, legs, and intertriginous parts of the body. Impetigo is common in the diaper area, particularly in the first 6 months of life and during the warmer summer season. The lesions are usually bullous and represent infection by Staphylococcus aureus. Folliculitis appears as small, perifollicular erythematous papules and pustules, usually on the buttocks, thigh and lower abdomen. It is common in the warm summer months and is usually caused by bacteria such as S. aureus. Intertrigo categorizes disease that does not fit into the above categories. Often the patient presents with simple erythema of the folds without pustules or induration. This probably represents irritation and low-grade infection. It is important for the clinician to be aware that many other diseases can have manifestations in the diaper area.(ABSTRACT TRUNCATED AT 250 WORDS)

Candidiasis, Cutaneous↗
PubMed1988

Topical antibiotics in dermatology.

Topical antibiotics are safe and effective in certain conditions, primarily acne, rosacea, and nasal carriage of Staphylococcus aureus. They are useful in impetigo only when it is of limited extent. Their efficacy in other pyodermas is unclear, although mupirocin is probably effective in many cases. In "infected eczema" that does not require systemic therapy they seem to add little to what topical corticosteroids alone achieve. They are ineffective in reducing the incidence of significant infection with indwelling intravenous catheters. They are safe preparations, but extensive use, especially in closed populations, may encourage the emergence of resistant bacteria.

Acne Vulgaris↗
PubMed1988

Group A streptococcal infection in children younger than three years of age.

We evaluated 758 sick children younger than 3 years of age for Group A beta-hemolytic streptococcal (GABHS) upper respiratory infection (URI) to determine the usual clinical presentation of the disease in this age group, indications for culture and the optimal site(s) from which to isolate the organism. GABHS infection was documented in 35 subjects (4.6%). The classic presentation (as proposed in the 1940s) of GABHS URI in children younger than 3 years of age was not confirmed by this study. In 32 of the GABHS cases there were pharyngitis, common cold symptoms or both, and these were associated with acute otitis media 10 times and with otitis media with effusion 3 times. Clinical impetigo was associated with GABHS URI (4 of 32 cases). GABHS URI would not have been documented in 6 of 32 cases if cultures of the anterior nares had not been performed. Children between 18 and 36 months of age were more likely to have GABHS disease than were younger children. Hoarseness and vomiting occurred less frequently in children younger than 36 months with GABHS infection than in those of that age who had non-beta-hemolytic streptococcal illnesses. A history of two or more siblings at home or a family member with a recent streptococcal infection and the presence of irritability, a reddened throat or palate or uvular edema were each associated with GABHS URI. We concluded that sick children between 18 and 36 months of age with a reddened throat should have cultures taken of the throat and anterior nares for GABHS.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteriological Techniques↗
PubMed1978

Clinical implications of preseptal (periorbital) cellulitis in childhood.

The available hospital records of all pediatric patients diagnosed as having periorbital, preseptal or orbital cellulitis over a five-year period were reviewed and compared to previously reported series. Only two of 39 patients had orbital cellulitis. The 37 patients with preseptal cellulitis had two characteristic clinical presentations. Twenty-two children had local trauma, abscesses, insect bites, or impetigo as the inciting event for their cellulitis. Infection was usually caused by staphylococci or streptococci. In contrast, 15 children, 12 of whom were under 36 months, had associated upper respiratory tract infections and otitis. Haemophilus influenzae was the most commonly implicated pathogen and the children were at risk of bacteremia and metastastic infection. Determination of the location of the infection in the orbit and consideration of the clinical presentation of the patient with infection in and about the orbit are of assistance in choosing appropriate therapy. Young children who have upper respiratory tract symptoms in association with preseptal cellulitis should receive antibiotic coverage for Haemophilus.

Abscess↗
PubMed1985

[A case of bouton d'orient].

Oriental Sore is the dry cutaneous form of leishmaniasis, a parasitic infection common to man and to certain vertebrates and transmitted by insects: the phlebotomes. This benign tropical disease exists in South East France where it remains very rare, human contamination always being accidental. The lesions, single or multiple, affect the skin only. On the face, the differential diagnosis arises with other much commoner cutaneous lesions (impetigo, etc.). They consist, after 2 to 4 months of incubation, of a rounded erythematous papule, neither pruritic nor painful, which becomes secondarily excavated to produce a crusted ulcer. This lesion, typical at this stage, then persists for many months before an unsightly scar develops. Treatment is local: surgical excision offering the possibility of histological examination and hence a diagnosis. Plastic surgery may be used to correct scars in advanced forms.

Diagnosis, Differential↗
PubMed1979

Clinical and laboratory studies with cefaclor: efficacy in skin and soft tissue infections.

Clinically relevant, recent isolates of common Gram-positive pathogens were examined for their in vitro susceptibility to cefaclor. Group A streptococci and pneumococci were uniformly sensitive (MICs 0.06--0.12 micrograms/ml) to both cefaclor and cephalothin. Cefaclor was 5--10-fold less active than cephalothin against group B streptococci. S. aureus strains were uniformly more susceptible to cephalothin than to cefaclor, but among isolates from children, almost all were sensitive to the latter drug. In clinical studies of patients with skin and soft tissue infections, cefaclor proved effective. Over 90% of patients with staphylococcal bullous impetigo, streptococcal and mixed streptococcal-staphylococcal forms of pyoderma were cleared after 7--10 day courses of treatment. In addition, twice-daily therapy, examined more recently, proved as effective in these forms of infection as did the conventional dose schedule. No significant adverse reactions were noted. Cefaclor appears to be an effective orally absorbed cephalosporin for common skin and soft tissue infections.

Adolescent↗
PubMed1984

Clinical and morphological recovery between two episodes of acute glomerulonephritis: a light and electron microscopic study with immunofluorescence.

A 4 year-old girl presented with 2 episodes of acute glomerulonephritis with clinical and morphological recovery between them. Both episodes were preceded by impetigo. The first and third renal biopsies showed glomerulitis with diffuse dense deposits in the mesangium, segmentary intramembranous dense deposits, atypical "humps" and granular C3. The second biopsy, taken between episodes, was considered to be normal. Two years and 5 months after the second episode the clinical evaluation and laboratory tests were normal.

Acute Disease↗
PubMed1980

Neonatal staphylococcal scalded skin syndrome: massive outbreak due to an unusual phage type.

A massive outbreak of the staphylococcal scalded skin syndrome due to an organism with an unusual phage pattern, occurred during a 115-day period and involved 68 newborns. Generalized exfoliative dermatitis was seen in 24 babies, and Staphylococcus aureus was isolated from 23. Fourteen isolates were phage typed, with 13 reported as the epidemic strain 29/79/80/3A/3C/54/75. Eight babies had generalized scarlatiniform eruption without exfoliation (staphylococcal scarlet fever). Cultural data were available from six, all positive for S aureus. Four organisms were typed and reported as the epidemic strain. Of 34 infants with bullous impetigo 20 had cultures that were positive for S aureus, and four were phage typed, revealing the epidemic strain. Illness was mild in all patients; there were no deaths and no invasive forms of staphylococcal infection. The male to female ratio of generalized exfoliative disease was 5:1. The concept of a neonatal staphylococcal scalded skin syndrome, comprised of a triad of skin disorders induced by an exotoxin elaborated by certain strains of coagulase positive S aureus, is confirmed.

Disease Outbreaks↗