Monday, November 28, 2005


Staph Skin Infections in Children

Like many teens, Amy had occasional outbreaks of zits on her face, and sometimes on her back and shoulders, too. But the bump that was growing on her neck was different. It had started out fairly small and itchy, but now it was big and red and sore. So Amy asked her mom to take a look. She was surprised when her mom said that the bump was a boil, an infection caused by staph (pronounced: staff) bacteria.

What Is a Staph Infection?

Staph is the shortened form of Staphylococcus (pronounced: staf-uh-low-kah-kus), a type of bacteria. These bacteria can live harmlessly on many skin surfaces, especially around the nose, mouth, genitals, and anus. But when the skin is punctured or broken for any reason, staph bacteria can enter the wound and cause an infection.

There are more than 30 species in the staph family of bacteria; however, most staph infections are caused by the species Staphylococcus aureus (S. aureus). Although the other species of staph bacteria were once believed to be innocent, non-disease-producing inhabitants of skin, it is now known that they can cause illness. For example, other types of staph bacteria can cause urinary tract infections in sexually active adolescents and young women.

S. aureus most commonly causes skin infections like folliculitis, boils, impetigo, and cellulitis that are limited to a small area of a person's skin. But once it enters the bloodstream through a break in the skin, S. aureus can also cause more serious infections in other parts of a person's body, such as the lungs, bones, joints, heart, blood, and central nervous system. These infections are more common in people with certain chronic diseases, in people who are having surgery, and in those with a weakened immune system.

S. aureus can also release toxins (poisons) that may lead to illnesses like food poisoning or toxic shock syndrome.

Who Gets Staph Skin Infections?

Kids, teens, and adults can all develop staph skin infections. People with skin problems like burns or eczema may be more likely to get them, though.Warm, humid environments also contribute to staph infections, and excessive sweating can increase a person's chances of developing the infection. Clusters of cases can occur in groups of people who live in crowded conditions (such as in college dorms), often as a result of poor hygiene and sharing of things like linens and clothing. People who have health problems such as diabetes, malnutrition, cancer, HIV infection, or any other condition that weakens the immune system may be more likely to get more serious staph infections.

What Are the Symptoms of a Staph Skin Infection?

The symptoms a person gets from a staph skin infection depend on the form that the infection takes. Some of the more common staph skin infections are listed below.

Folliculitis (pronounced: fuh-lih-kyoo-lie-tus) is an infection of the hair follicles, the tiny pockets under the skin where hair shafts (strands) grow. In folliculitis, tiny white-headed pimples appear at the base of hair shafts, sometimes with a small red area around each pimple. This occurs often where people shave or have irritated skin from rubbing against clothing.
A furuncle (pronounced: fyoor-un-kul), commonly known as a boil, is a solitary swollen, red, painful lump in the skin, usually due to an infected hair follicle. The lump usually fills with pus, growing larger and more painful until it ruptures and drains. Furuncles are most frequently found on the face, neck, buttocks, armpits, and inner thighs, where small hairs can often be irritated. A cluster of several furuncles is called a carbuncle (pronounced: kar-bun-kul). A person with a carbuncle usually feels ill and feverish.

Impetigo (pronounced: im-puh-tee-go) is a superficial skin infection seen most commonly in young children, but it can sometimes affect adolescents and adults. Most impetigo infections affect a person's face or extremities like the hands and feet. An impetigo lesion begins as a tender, red bump that evolves into a small blister or pimple, and then develops a honey-colored crust. It is a mild condition with no pain or fever, although impetigo blisters may itch and can be spread to other parts of the body by scratching.

Cellulitis (pronounced: sell-yuh-lie-tus) is an infection involving areas of tissue below the skin surface. It begins as a small area of redness, pain, swelling, and warmth on the skin. As this area begins to spread, it can be accompanied by fever and a generally ill feeling. Cellulitis can affect any area of the body, but it's most common on the face or lower legs.

A hordeolum (pronounced: hore-dee-oh-lum), commonly known as a stye, is an infection in the eyelid. It develops when the glands that are connected to the base of the eyelash become obstructed. A person with a stye will usually notice a red, warm, uncomfortable, and sometimes painful swelling near the edge of the eyelid.

Wound infections are generally seen 2 or more days after trauma or surgery. The signs of a wound infection (redness, pain, swelling, and warmth) are similar to those found in cellulitis. A wound infection may be accompanied by fever and a generally ill feeling. Pus or a cloudy fluid can drain from the wound and a yellow crust (like that in impetigo) can develop.

Can I Prevent a Staph Skin Infection?

Staphylococcus aureus bacteria are everywhere. Many healthy people carry staph bacteria in their noses and other parts of the body at various times without getting sick. Our fingers can carry staph bacteria from one area of the body to another, causing infections in wounds or broken skin. Staph bacteria can also spread from person to person, and occasionally through droplets in the air or on contaminated surfaces of objects.
Hand washing is the best way to prevent staph (and other) infections. You can help prevent staph skin infections by bathing or showering daily.

Keep areas of skin that have been injured - such as cuts, scrapes, areas affected by eczema, and rashes caused by allergic reactions or poison ivy - clean and covered, and use any antibiotic ointments or other treatments that your doctor suggests. If someone in your family has a staph infection, don't share towels, sheets, or clothing until the infection has been fully treated.
If you develop a staph infection, be careful not to touch the infected skin. This will prevent the infection from spreading to other skin areas. If you can, keep skin areas affected by staph infections covered to prevent spreading the infection to other parts of the body.

Should I Call My Doctor?

You should call your doctor if you have an area of red, irritated, or painful skin, especially if you see whitish, pus-filled areas or if you have a fever. Also, call your doctor if skin infections seem to be passing from one family member to another or if two or more family members have skin infections at the same time.

How Are Staph Infections Treated?

You can treat most small staph skin infections that aren't serious at home by washing the skin with an antibacterial cleanser, applying an antibiotic ointment, and covering the skin with a clean dressing. To prevent the spread of infection, use a towel only once when you clean an area of infected skin, then wash it in hot water (or use disposable towels).

If an infection becomes severe and turns very red or becomes very sore or is accompanied by fever or a generally ill feeling, you should call your doctor. For severe infections, your doctor may prescribe an antibiotic for you. If so, be sure to take your antibiotic as prescribed for as many days as your doctor directs. If a person has a large, pus-filled staph infection, it may need to be drained by a doctor.

What Can I Do to Feel Better?

The time a staph skin infection take to heal varies depending on the type of infection and whether a person gets treatment for it. A boil, for example, may take 10 to 20 days to heal without treatment, but treatment will speed this process up. Most styes, on the other hand, go away on their own within several days.

To help relieve pain from a skin infection, try soaking the skin in warm water or applying hot, moist washcloths to the area. You can also apply a heating pad or a hot water bottle to the skin for about 20 minutes, three or four times a day. Pain relievers like acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) can help reduce pain until the infection subsides
Styes can be treated using warm compresses over the eye (with the eye closed) three or four times a day. Occasionally, a stye will require a topical antibiotic. See your doctor if a stye doesn't go away in a few days.

If you get a staph infection on skin areas that you normally shave, avoid shaving, if possible, until the infection clears up. If you do have to shave the area, use a clean disposable razor or clean your electric razor after each use.

Updated and reviewed by: Elana Pearl Ben-Joseph, MDDate reviewed: October 2003Originally reviewed by Stephen Eppes, MD


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