Severe Bullous Impetigo in A 4-Month-Old Infant: A Case Report

Abstract

Background: Impetigo is a skin bacterial infection that mainly affects the superficial skin; however, it can spread deeper into the tissues. It commonly affects children under 5 years of age. It frequently occurs in crowded areas such as daycare centers, and schools that have poor hygiene. There are two forms: bullous and non-bullous impetigo (impetigo contagiosa). Non-bullous impetigo is more common and is mostly seen as a secondary infection in conditions that affect the skin.

Case Presentation Summary: We present an interesting case of a 4-month-old male infant brought to our pediatric outpatient clinic with a one-week history of fragile fluid-filled vesicles, flaccid blisters, and peeling of the skin. Multiple fluid-filled vesicles and flaccid blisters were present mainly on the scalp, face, neck, part of the trunk, and upper limbs. The mother reported having received a prior treatment 3 days before of calamine lotion and erythromycin. However, the symptoms were increasing gradually and the vesicles enlarging. No other medication was given.

Conclusion: Skin changes and skin-related problems occur frequently in children and account for about 30% of pediatric primary care visits. There are many different causes of pustules in childhood including infectious and non-infectious causes. Clinical suspicion and culture and sensitivity are important guides in diagnosis. Besides, Pediatric dermatology services and mentorship are highly inaccessible, especially in low and middle-income countries. This greatly impacts the management of pediatric dermatology cases as many are either misdiagnosed or take a long referral process.