Review article

Non-necrotising bacterial infections of the skin

Ivan Puljiz ; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Tomislav Bruketa ; Zavod za gastrointestinalnu kirurgiju, Klinika za kirurgiju, KBC Zagreb, Zagreb, Hrvatska

Abstract

The skin is a barrier colonized with apathogenic bacteria that limit the invasion and growth of pathogenic bacteria. The most common bacterial infections of the skin are pyodermas caused by Beta-hemolytic streptococcus (BHS) or Staphylococcus aureus (SA). Impetigo is a superficial skin infection caused by BHS or SA, that most commonly affects preschool children. Therapeutic approach depends on the number and size of skin changes. Skin abscess requires incision, pus drainage, and sometimes antimicrobial therapy. Folliculitis, furuncles, and carbuncles are infections of the hair follicle in general caused by SA that differ in the extensiveness of inflammation. Erysipelas and cellulitis pathohistologically differ in depth of the affected skin, and clinically in the appearance and morphology of skin lesions. Skin changes are preceded by systemic manifestations of infection. Etiological diagnosis of erysipelas/cellulitis is rarely established. Apart from BHS and SA, also some other bacteria may cause cellulitis, in some special circumstances. Diagnosis of erysipelas/cellulitis is based on clinical presentation of disease. However, streptococcal and staphylococcal skin infections cannot be clinically distinguished. It is important to timely recognize necrotizing soft tissue infections that require rapid surgical intervention. The treatment of erysipelas/cellulitis includes antimicrobial therapy lasting for 10 days, and sometimes even longer. After successful completion of treatment, in patients with recurrent erysipelas/cellulitis appropriate preventive measures need to be implemented, which include proper hygiene measures, treatment of accompanying risk factors, eradication of carriage of potential pathogens, and in some cases, prophylactic use of antibiotics. Orbital cellulitis is a serious condition that can cause severe consequences and should be distinguished from preseptal cellulitis which is a mild disease. Perianal abscess requires immediate surgical drainage and sometimes also antimicrobial therapy.

Keywords

Bacterial skin infections; Staphylococcus aureus; Streptococcus pyogenes

Hrčak ID:

133452

URI

https://hrcak.srce.hr/133452

Publication date:

31.3.2014.

Article data in other languages: croatian

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