Case report: crustose impetigo with secondary infection in a 25-day-old infant

Abstract

Background: Impetigo is a superficial skin infection of the epidermis caused by gram-positive bacteria. The disease often affects children, with a global prevalence of about 12.3%. Symptoms of crustose impetigo begin as red papules that develop into vesicles, then burst and form yellowish, honey-like crusts, especially on the face, neck, back, and extremities. This study aims to describe a case of impetigo crustosa in an infant.   Case presentation: A 25-day-old infant patient developed crustose impetigo with complaints of yellowish crusts on the face that initially consisted of reddish patches and watery clusters, which ruptured before hospitalization. The primary predilection of crustal impetigo is the area around the nose and mouth, with lesions also appearing on the extremities. The patient was given topical and systemic treatment. In this case, a compress was applied to the lesion using 0.9% NaCl. Systemic antibiotics were indicated in this case because there was a secondary infection. The choice of intravenous antibiotics was based on the neonate's inadequate oral intake.   Conclusion: Impetigo is a common condition in children, often presenting as crusted impetigo. It typically begins as erythematous papules that progress into vesicles or pustules. Secondary infections can occur, mainly if there are pre-existing skin lesions or underlying dermatological conditions exacerbated by scratching. In cases of uncomplicated impetigo contagiosa, empirical treatment can be initiated without the need for diagnostic testing. Management generally involves either topical or systemic therapy, depending on the severity and extent of the infection.