Impetigo - Complications of impetigo

Complications of impetigo are rare, but they can sometimes occur and can be serious. Tell your GP if you have impetigo and your symptoms change or get worse.

Some complications associated with impetigo are described below.

Cellulitis

Cellulitis occurs when the infection spreads to a deeper layer of skin. It can cause symptoms of red, inflamed skin with fever and pain. It can usually be treated with antibiotics, and painkillers can be used to relieve pain.

Guttate psoriasis

Guttate psoriasis is a non-infectious skin condition that can develop in children and teenagers after a bacterial infection. It is usually more common after a throat infection, but some cases have been linked to impetigo.

Guttate psoriasis causes small, red, droplet-shaped, scaly patches on the chest, arms, legs and scalp.

Creams can be used to control the symptoms and in some cases the condition will disappear completely after a few weeks.

Scarlet fever

Scarlet fever is a rare bacterial infection that causes a fine, pink rash across the body. Associated symptoms of infection, such as nausea, pain and vomiting, are also common. The condition is usually treated with antibiotics.

Scarlet fever is not usually serious but it is contagious. Therefore, it's important to isolate an infected child and avoid close physical contact. Keep your child away from school and other people until they have been taking antibiotics for at least 24 hours.

Septicaemia

Septicaemia (a type of sepsis) is a bacterial infection of the blood. It can cause:

• diarrhoea
• cold, clammy skin
• a high temperature (fever)
• rapid breathing
• vomiting
• low blood pressure (hypotension)
• confusion
• feeling faint and dizzy
• losing consciousness

Septicaemia is a life-threatening condition and requires immediate treatment with antibiotics in hospital.

Scarring

In rare cases, impetigo may lead to some scarring. However, this is more often the result of someone scratching at blisters, crusts or sores. The blisters and crusts themselves should not leave a scar if left to heal.

The red mark left after the crusts and blisters clear up should also disappear by itself. The time it takes for the redness to disappear can vary between a few days and a few weeks.

Staphylococcal scalded skin syndrome

Staphylococcal scalded skin syndrome (SSSS) is a serious skin condition in which one of the causes of impetigo – Staphylococcus bacteria – releases a toxin (poison) that damages the skin.

This leads to extensive blistering that looks like the skin has been scalded with boiling water.

Other symptoms of SSSS include:

• painful skin
• a high temperature (fever)
• large areas of skin peeling off or falling away
• redness of the skin which usually spreads across the entire body

SSSS usually requires immediate treatment in hospital with antibiotics given directly into a vein (intravenously).

Post-streptococcal glomerulonephritis

Post-streptococcal glomerulonephritis is an infection of the small blood vessels in the kidneys. It's a very rare complication of impetigo.

The symptoms of post-streptococcal glomerulonephritis include:

• a change in the colour of your urine to a reddish-brown or cola colour
• swelling of the abdomen (tummy), face, eyes, feet and ankles
• a rise in blood pressure
• visible blood in your urine
• a reduction in the amount of urine you would normally produce

People with post-streptococcal glomerulonephritis will usually require immediate hospital treatment so their blood pressure can be carefully monitored and controlled.

Post-streptococcal glomerulonephritis can be fatal in adults, although deaths in children are rare.