Impetigo

You might have never heard about this word, maybe you've heard it multiple times, or even heard it said differently such as Infantigo. But what is this skin infection called Impetigo?

 

What is Impetigo?

Impetigo is a very common skin infection seen mainly in children that is usually caused by a bacteria called Staphylococcus Aureus (AKA Staph). It may occur anywhere on the skin, but usually in areas that have received some cut, trauma, bite, or abrasion. The face near the nose is a very common area to see these lesions. Sometimes it can occur after a runny nose causing irritation of the skin, leading to Impetigo.

 

What does it look like? 

It can start as very tiny sores, pustules, or small blisters, and as they rupture they develop a honey-colored crust on top, very characteristic. Impetigo does have a less common variant, called bullous Impetigo. This type has large bullae, like blisters, on the trunk, but can occur anywhere too. 

 

Can it spread? 

It usually starts as one lesion that spreads very easily due to scratching. It may spread from under the nails to other areas nearby or elsewhere on the body. To prevent this spread it is important to keep the nails short and clean, also to avoid scratching and touching the lesions.

 

It can also spread to other children by directly touching them or surfaces they might touch. It is very common in certain sports due to the direct contact, such as wrestling or football.  It is highly contagious!

 

Can it be treated? 

Yes! It is treated with antibiotics. The first line of treatment, unless severe and already expanded, is a topical antibiotic cream or ointment such as Mupirocin 2%. This is used 2-3 times a day on the affected lesions for 7 days. It tends to improve within 48hrs. 

 

In certain cases, where the lesions have already spread, they are resistant to the topical treatment, or it has been diagnosed or treated late, it is recommended to take oral antibiotics, such as Cephalexin. 

 

Can it be resistant to standard antibiotics?

In certain cases, it can be MRSA impetigo. This means it is caused by a Staph strain that is resistant to standard antibiotics and needs to be treated with stronger antibiotics such as Clindamycin. 

 

Is it dangerous?

Most Impetigo is pretty benign; it heals without scarring. But it can sometimes cause complications, such as:

• Cellulitis: infection that affects the tissue under the skin and can spread to the bloodstream. This can become life threatening if left untreated.
• Glomerulonephritis (kidney problem): Impetigo can cause a reaction in the kidneys that can lead to kidney damage.

What should I do once my child has it?

1. Call your pediatrician or telehealth service for antibiotic treatment.
2. Keep nails short and clean.
3. Wash linens, clothes and towels with hot water.
4. Avoid sharing towels and clothes.
5. Keep lesions covered when in contact with other children.
6. Try to keep lesions loosely covered, the scabs need airflow to heal. 
7. If attending school, sports or daycare, always cover lesions. 
8. If not improved after 2-3 days of starting the ointment (or oral antibiotic if needed), seek medical care again.

When can your child go back to school, daycare?
24 hours after starting the antibiotic (topically or orally) kids may return to daycare, school, or sports.

 

Can they get it again?

Unfortunately, yes. Many children have this infection recurrently. They might even be colonized by the bacteria, usually in their nose, even though they may not have symptoms in their nose. This colonization can lead to a child getting Impetigo after any minor skin lesion such as insect bites. If the infection is recurrent, your pediatrician may want to swab your child’s nose to check for the staph bacteria.

 

If you have any questions about Impetigo, please log into your account and send us your question. We are here to help.

 

Dr. Valerie Hines, MD FAAP

Healthy Communication, Part 2: Team Members

Sarah Miller had been a high school history teacher for nine years. She'd always liked the school administration and her colleagues.

 

But in mid-March 2020, the pandemic hit, and Sarah, like all teachers at her school, was sent home to teach classes remotely. 

 

Little by little, the COVID-19 crisis began to take its toll. Sarah was feeling increasingly stressed.  

 

Unexpected demands had become part of her everyday life. Having to learn new technology platforms to improve the quality of virtual teaching left her feeling overwhelmed and defeated.

 

Sarah felt as if every time she began to settle into the "new normal" of her job, the government passed new laws in response to the pandemic. District leaders imposed changes in school directives, and Sarah was back at square one.

 

A few weeks into the process, Sarah uttered something she never thought she'd hear herself say: "I hate my job." She couldn't put her finger on what was wrong. Sarah was unaware of the fact that she was mourning the loss of some people and things that had previously given her a sense of stability and well-being:

 

The personal connection with other teachers, in particular, her two closest friends who taught alongside her in the history department. 

 

The experience of interacting face-to-face with kids. As a teacher, Sarah's "edge" was inserting her fun and energetic personality into the classroom. For the previous two years, students had voted her their favorite teacher.

 

The security of using a proven teaching and classroom management plan she had created and fine-tuned over the course of her teaching career.

 

In addition to the stress that resulted from these losses, fear had crept into Sarah's thinking. Worrying that she wouldn't be able to keep up with the ever-changing requirements of virtual teaching created an underlying feeling of panic. How would she stay connected to her colleagues and keep students engaged with history?

 

Like Sarah, we all know what it means to be stressed. The term "stress" can refer to a wide variety of phenomena: 

• We experience stress when pressures or demands make our lives difficult or interfere with our ability to maintain a feeling of well-being. 
• Sometimes people describe "feeling stressed" as an emotional state, one that involves anxiety and exhaustion. This is often referred to as "burnout".
• A situation that overwhelms a person's perceived ability to meet the demands of that situation is experienced as stress.

One strategy for addressing stress in our lives is to communicate in a healthy manner. This begins with the way we approach circumstances and the messages we tell ourselves. For example:

• Taking small positive actions on a daily basis is more effective than attempting to make radical changes overnight.
• Blaming discomfort on outside events keeps us from facing the real issue - our attitudes. We have choices. We can either see ourselves as victims, or we can accept what is happening and take responsibility for our response.
• Focusing our energies on what we can control and letting go of what we cannot control reduces the frustration and resentment that result from unrealistic expectations.
• Condemning ourselves for our imperfections robs us of the opportunity to see and celebrate progress. 
• Asking for help is a sign of strength, not weakness.
• Searching for "the" answer prevents me from identifying and exploring viable options.

Equally important as what we tell ourselves is how team members treat and talk to one another. We each have the power to reduce stress through building connectedness and community. This becomes possible when we: 

• Invite others to be part of what we are working on. 
• Initiate conversations about the goals we have for ourselves and what we're doing to reach them.
• Agree on a clear and commonly accepted team purpose.
• Discover obstacles that can be removed in order to achieve personal and collective goals.

After recognizing that fear and discomfort had been contributing to her stress and frustration, Sarah realized she had the power to make choices that would improve her sense of well-being. Over time, she began taking specific steps toward adapting the way she communicated with herself and colleagues in light of the challenges of COVID-19. 

 

Sarah's stress and frustration with her job began to turn around when she asked: "Am I willing to change? What do I have the power to change? Which actions will have the greatest impact on achieving these changes?"

 

If you have any questions about healthy communication, please log into your account and send us your question. We are here to help.

 

Dave Tarpley, MEd

Consultant and Executive Coach 

 

For more on Dave click here.

Healthy Communication, Part 1: Leaders

As a young boy growing up in a coastal Florida city, the threat of hurricanes was frequent and distressing.

 

Several Category 4 hurricanes slammed their way through our neighborhood. I distinctly recall watching three towering pine trees in our front yard crash to the ground within minutes of each other, one of which smashed into our house.  If we still had power, my dad would tune the television to the local weather station to track the hurricane's path. The weatherman was our leader, the one we were counting on to steer us to safety.

 

During this “hurricane” called Covid-19, progressive leaders understand that creating and managing a crisis-communications program requires the same commitment they give to other parts of the organization. Above all, they put their people first. When leaders prioritize employees' safety and morale, not just business needs, people feel protected and supported.

 

What kinds of strategies might be part of a crisis-communications program? 

• In uncertain times, effective leaders consistently communicate to their people how they uniquely contribute to the organization's goals and values. This gives them a sense of motivation, fulfillment, purpose, and belonging, inspiring them to act because they want to, not because they have to.
• Not surprisingly, healthy communication is characterized by a high level of trust. When people feel safe they can ask for help, admit mistakes, and take responsibility. These acts of vulnerability feel risky. A leader who models vulnerability gives others the courage to take off their masks and be real. 
•  Healthy companies are a place where people are recognized for their intrinsic value, rather than as a cost unit, function, or sum total of their achievements. Leaders spend less time trying to exert control and more time building cooperation with their team members. 
•  A problem some people experience in times of uncertainty is fear of the unknown. A way to combat that fear is to establish a few “certainties” in the form of structure and routines. Regularly-scheduled Zoom meetings or on-site group meetings that allow for employee input, time for questions and answers, and even laughter, help people live in the present and feel connected. This reduces anxiety and increases focus.
•  It is also helpful to provide your team with tangible action items. Having specific next steps gives people a sense of control and the reassurance that they are making a contribution toward stabilization. Use words like, “Here are the next steps we are taking” or “Here's what you can do” to demonstrate action. 
•  By not withholding information, leaders can build trust with their team and create a bond. As a leader, it is essential to be honest about successes and failures, goals, and financial activities. Changes that could negatively impact the team should be shared truthfully. Promoting transparency will allow your team members to feel comfortable voicing their concerns to you and their colleagues while reducing possible conflict areas and building trust. 

Natural disasters like hurricanes and earthquakes invariably leave behind them a path of destruction. But as they “rise from the ashes”, homeowners and business leaders have the opportunity to rebuild, but differently. They call in architects who can design structures that are safer and more solid, better able to withstand inevitable future calamity.

 

Ultimately, the benefit of having a crisis-communication program is that it clarifies the kind of organization you want to have. Will your organization focus on goals at the expense of valuing the needs of your people? Or will you recognize that your people are your most treasured resource in the quest to reach those goals? The answers to these questions form the way you communicate with your employees, and allow you to seamlessly transition from crisis mode to a new normal.

 

I am not a quantitative researcher. My conclusions about people and organizations aren’t rooted in statistics or data. I am a consultant and executive coach who asks questions that guide people in exploring what they are willing to do differently in order to get different results.

 

What is possible if you become willing to do something different? What do you risk if you don’t?

 

If you have any questions about healthy communication, please log into your account and send us your question. We are here to help. 

 

Dave Tarpley, MEd Consultant and Executive Coach

 

For more on Dave click here.