BACTERIAL INFECTION

Pyoderma refers to any skin infection caused by pyogenic (pus-forming) bacteria and is commonly associated with bacterial skin infections. These infections can range from superficial to deep, with symptoms varying based on the severity of the infection. Common bacterial skin conditions include folliculitis, furuncles, carbuncles, abscesses, and cellulitis. Impetigo is discussed separately as it is a distinct type of bacterial skin infection.

CAUSES

The primary bacteria responsible for causing folliculitis, furuncles, carbuncles, ecthyma, abscesses, erysipelas, and cellulitis are typically Staphylococcus and Streptococcus. Occasionally, less common bacteria such as Pseudomonas, Klebsiella, and others may also play a role as causative pathogens.

Factors that increase the risk of developing superficial bacterial infections such as folliculitis, furuncles, or carbuncles include:

• Poor hygiene,
• Immuno-compromised status,
• Skin to skin contact with infected person
• Contact with object carrying these bacteria
• Nasal carriage
• Occlusion of hair follicle
• Excess sweating
• Scratching in Dry skin
• Long use of topical steroid
• Long term antibiotic therapy for other disease
• Shaving against direction of hair growth
• Hot bath rewrite these points

Symptoms of superficial bacterial infection

Folliculitis:Folliculitis typically manifests as red or pus-filled (yellow-colored) bumps originating from hair follicles, often accompanied by itching and pain. It can occur in any area of the body with hair. Scalp and facial folliculitis are commonly caused by simple bacteria, whereas folliculitis in areas like the chest, scrotum, flanks, and periumbilical region is often due to resistant bacteria.

"Folliculitis barbae" (also known as sycosis barbae) occurs in the beard area and affects the deeper parts of multiple hair follicles.

"Hot tub folliculitis" is caused by Pseudomonas bacteria and typically appears as a rash or red/yellow bumps 8 to 48 hours after contact with contaminated water. It mainly affects the bathing suit area.

Gram-negative folliculitis is linked to prolonged use of oral antibiotics and commonly involves the peri-oral and peri-nasal areas.

Furuncle:It affects the deeper layers of the hair follicle and appears as a quickly developing, painful, red swelling that can increase in size and become softer over time. After it ruptures, symptoms typically improve, but there may be a risk of recurrence without treatment. Commonly affected areas include the face, neck, underarms, waistline, and perineum. Systemic symptoms like fever and body aches are usually absent.

Carbuncle:When multiple furuncles merge, they can form a carbuncle that extends deep into the fat layer. This may result in multiple pus-discharging openings on the skin and occasionally lead to the formation of an ulcer. Carbuncles are commonly found in areas with thick skin, such as the back of the neck, hips, and thighs. Systemic symptoms may also be present

Abscess: Abscesses are painful collections of pus that are localized and fluctuant, involving the skin and fat layers with varying degrees of inflammation. They can occur at any site and may follow a furuncle or carbuncle. Abscesses can develop with or without cellulitis, and systemic symptoms are uncommon.

Cellulitis & erysipelas:Cellulitis affects the deep layers of the skin, while erysipelas is a superficial variant because it involves the outer layers of the skin. The key features include skin redness, swelling, and warmth, typically localized to the affected area. Superficial fluid-filled vesicles may also be present. Severe infections may lead to fever and body aches. These conditions often affect one side of the body, with lower limbs being the most common site. After resolution, peeling of the skin (desquamation) and pigmentation changes may occur.

Treatment of skin bacterial infection

Treatment of bacterial skin infections involves:

• Antibiotics: Oral or topical antibiotics are commonly prescribed to target the bacteria causing the infection. The choice of antibiotic depends on the severity of the infection and the type of bacteria involved.
• Pain management: Over-the-counter pain relievers may be recommended to manage discomfort and pain associated with the infection.
• Warm compress: Applying a warm compress to the affected area can help reduce inflammation and promote drainage of pus in some cases.
• Proper wound care: Keeping the affected area clean and dry, and covering it with a sterile dressing can help prevent further infection and promote healing.
• Follow-up care:It's important to follow up with a healthcare provider to monitor the progress of the infection and ensure that it is responding well to treatment.