Pyodermal Bacterial Skin Diseases : What Is It ? Nursing Management, Treatment, And Advice For Patient
Erysipelas
Erysipelas is skin infection caused by staphylococcal pyogens or B-hemolytic streptococcus, characterized by well-demarcated erythema and swelling on the face or extremities associated with pain and fever.
The distinctive features of erysipelas are well-defined erythema with indurated margin particularly among nasolabial fold rapid progression and intense pain flaccid bullae may develop during the second and third days of illness.
Treatment
-Penicillin is the drug of choice which is given if the lesion becomes bullous or to higher level
-Anti pain
-General skin care- cleaning the skin and applying antiseptic cream
-Encourage personal hygiene like regular washing hands
Boil (Furuncle)
Definition – Bacterial infection of hair follicles
-A furuncle is an infection of a hair follicle and curbancle infection of more than one hair follicle
-It often occurs as an extension a superficial folliculitis
-These infections often occur in hairy areas of the body, especially where there is perspiration and friction.
Cause
Staphylococcus aurous
Clinical presentation
The lesion develops into a hard, red, tender nodule which often brusts, discharging pus and frequently a solid core of necrotic tissue.
*It is rarely accompanied by systemic symptoms, when the lesions are multiple
Clinical finding
Gram stains and cultures of the drainage may be used to definitively establish the causative organism but mostly diagnosed is clinical
Treatment
For simple furuncle, the primary treatment is usually the application of warm, moist packs, to help the body localize the infection and mobilize its normal phagocytic response, thereby promoting drainage of the infectious site. Topical antibiotic cream and systemic antibiotic for multiple lesions
Carbuncle
Definition
A carbuncle is a deeper infection involving several follicles, often forming a collection of pus or abscess. It is painful usually associated with fever. The common site includes neck, thighs, and back.
Cause
Like furuncles the causative organism is generally a staphylococcus aureus/streptococcus
Clinical presentation
The involved area of the skin is usually red, indurate, and painful with multiple pustules and several draining points with purulent drainage. The lesion often develops a yellow gray crust at the center, which is permanent and readily visible scar.
• It is frequently associated with fever; pain and malaises & white blood count sometimes reveals leukocytosis.
Treatment: systemic antibiotic, drainage of abscess, local skin care and dressing.
Predisposing factors:
• Diabetes mellitus
• Immune suppress (HIV long term steroid treatment)
• Poor hygiene and worm climate
Treatment
Systemic antibiotic, drainage of abscess, local skin care and dressing
Complication
-Manipulation of furuncles on the face may cause sinus thrombosis and total pyemia.
-Other possible complications of manipulated furuncles are
- Perinephric abscess
- Osteomyelitis
- Endocarditis
• Bacteremia and other secondary infections can occur.
Nursing management of furuncle & carbuncle (treatment)
• Control fever and pain
• Teach patient to take adequate fluid, food and rest to enhance the healing process
• Monitor the affected local area & the development of systemic progression
• Apply warm and moist packs
• Teach patient to avoid any manipulation to the infected area
• Teach patient about prescribed medications
• Treat with systemic antibiotics
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