Bullous Impetigo in 14-Month-Old Male Infant
Case at a Glance
A 14-month-old male infant presented with a progressive skin rash that began as a single lesion on the arm and spread to multiple body sites over several weeks. The lesions were non-pruritic and not associated with fever.
Patient's Story
The patient's caregivers reported that the rash initially appeared as a single lesion on the child's arm approximately 2-3 weeks prior to consultation. Over time, additional lesions developed on various parts of the body. The infant showed no signs of discomfort, fever, or itching. Bath routine remained consistent with daily evening baths using the same products. The child demonstrated a preference for cooler water temperatures, as warmer water caused apparent discomfort during bathing.
Initial Assessment
Physical examination revealed multiple skin lesions consistent with a bacterial skin infection. The lesions appeared bullous in nature with characteristic morphology. The patient was afebrile and appeared comfortable with no signs of systemic illness. No evidence of pruritus was observed.
The Diagnostic Journey
Initial differential diagnosis included viral exanthem, impetigo, and ringworm. However, clinical presentation and lesion characteristics were most consistent with a bacterial etiology. The bullous appearance and distribution pattern suggested staphylococcal impetigo rather than streptococcal impetigo or other infectious causes.
Final Diagnosis
Bullous (Staphylococcal) Impetigo - a superficial bacterial skin infection caused by Staphylococcus aureus, characterized by fluid-filled blisters that rupture easily.
Treatment Plan
Systemic antibiotic therapy was initiated to address the bacterial infection. Topical treatments were considered as adjunctive therapy. Patient education was provided regarding hygiene measures and prevention of spread to other household members.
Outcome and Follow-up
Patient responded well to antibiotic treatment with resolution of lesions expected within 7-10 days. Follow-up was arranged to monitor treatment response and ensure complete resolution of the infection.