Bacterial skin infections

Symptoms Of Bacterial skin infections

The symptoms of bacterial skin infections vary depending on the type and severity of the infection. The general symptoms include:

• Erythema (redness of the affected area)

• Pain 

• Warmth

• Swelling 

• Liquidy discharge from a wound

• Swelling of lymph nodes

Erythema may not be much visible in individuals with a darker skin tone.

Some bacterial skin infections can progress at a speedy rate. The severe infection may also lead to:

• Fever

• Chills

• Increase in heart rate

• Altered mental status

• Blisters on the skin that are filled with clear fluid

• Crepitus (unusual crackling sensation while palpating the skin)

Causes Of Bacterial skin infections

The skin provides the primary protection against environmental exposures. Bacteria that disrupt this protective barrier cause bacterial skin infections. 

Several bacteria cause skin infections. However, most of the infections are caused by the following: 

• Group A Streptococcus (GAS), often called "strep."

• Staphylococcus aureus, commonly called "staph."

Other bacteria include:

• Corynebacterium species

• Neisseria species

• Haemophilus species

• Helicobacter pylori

• Klebsiella rhinoscleromatis

• Mycoplasma pneumonia

• Pseudomonas aeruginosa

• Calymmatobacterium granulomatis

Types Of Bacterial skin infections

Bacterial skin infections are of several types. The most commonly found types include:

1. Cellulitis

It refers to an infection of deep skin. The affected area becomes painful and swollen with asymmetrical borders. The most common areas involved are legs and arms. Other sites, such as the face, feet, hands, torso, neck, and buttocks, can also be involved. 

2. Erysipelas

It is a form of cellulitis that usually affects the upper layer of the skin. It involves fiery red, painful infection with sharply demarcated borders. The common sites are the legs and face. 

3. Impetigo 

It usually appears as reddish sores on the face, especially around the nose and mouth. Sores can also appear on hands and feet. It is more commonly seen in children aged 2 to 5 years. 

4. Folliculitis 

Folliculitis is an inflammation of the hair follicles. Individuals with folliculitis often experience pus-filled lesions on the skin.

5. Furuncle (boils)

It refers to the severe form of folliculitis in which the infection progresses deeper and extends out from the follicle. The infection starts as painful lesions filled with pus. The most common affected areas are the neck, armpits, thighs, and buttocks.

6. Carbuncle 

This is also the progressed form of folliculitis. In this, an aggregate of hair follicles develops. These aggregates form large swollen lesions that often open and discharge.

All of the above infections are usually caused by Streptococcus or Staphylococcus species. 

Risk Factors For Bacterial skin infections

Any factor that allows bacteria to get through the skin increases the chances of bacterial skin infection:

1. Injuries

Skin injuries allow the bacteria to enter the deeper tissues through skin breaks. These injuries can result from the following:

• Scrapes

• Wounds

• Punctures

• Surgery

• Burns

• Sunburns

• Insect bites

• Ulcers

• Tattoos

• Piercings

• Preexisting skin diseases

Bacteria can also invade the skin through hair follicles on the skin surface.  

2. Medical conditions

Individuals with chronic skin conditions such as athlete's foot, eczema, chickenpox, and shingles are at increased risk of developing bacterial skin infections. 

3. Repeated Injections 

The repetitive use of injections also makes an individual prone to bacterial skin infections. 

4. Obesity

Due to increased fat, the skin of obese individuals has more significant skin folds. This makes the skin prone to bacterial growth, which may lead to infection. 

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5. Edema

Persistent swelling, especially in the arms and legs, can crack the skin. This may allow bacteria to enter beneath the skin, causing a skin infection. 

6. Diabetes

The complications of diabetes can cause cracks in the superficial layer of the skin and skin breakdown, which increases the chances of bacterial skin infection. The commonly observed bacterial skin infections in diabetics include cellulitis, folliculitis, impetigo, carbuncle, and furuncle.

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7. Low immunity

Individuals who have low immunity are at higher risk of bacterial skin infections. This includes: 

• Elderly people

• Individuals undergoing chemotherapy 

• Individuals taking any medication that suppresses the immune system

• People with Human Immunodeficiency Virus (HIV) infection 

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Diagnosis Of Bacterial skin infections

Most diagnoses of bacterial skin infections are made through physical examination. 

The following laboratory tests are used to determine the type of infection and assess complications in cases of severe clinical symptoms:

1. Blood tests

• Complete blood count: A persistent bacterial infection often causes a rise in the white blood cell count, which is determined through a complete blood cell count. The test also helps to distinguish a bacterial infection from a viral infection.

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• C-reactive protein (CRP): CRP is an inflammatory marker whose level increases during an infection. The detectable rise in CRP can take up to 24 hours after the onset of symptoms. 

• Procalcitonin is a type of protein released by various cells after a serious bacterial infection. An elevated level of procalcitonin may be a sign of sepsis. 

2. Skin culture

It involves examining a sample of skin, tissue, or exudates taken from the infected site. This test detects the type of microbes causing the infection and helps guide the right treatment plan. 

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Prevention Of Bacterial skin infections

Proper care of wounds, along with maintaining overall hygiene, helps in preventing bacterial skin infection. This can be achieved through the following measures:

1. Take proper care of the wounds

Wounds are the leading cause of infection. The proper care of wounds and injuries can help prevent bacterial skin infections. The following measures should be taken to keep the wounds away from bacteria:

• Wash hands with soap and water more frequently

• Use an alcohol-based hand rub if washing is not possible

• Keep the draining or open wounds clean 

• Keep the wounds and injuries covered with the dressings until they heal

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2. Do not ignore any break in the skin

Any puncture or break in the skin should not be ignored. It should be immediately consulted with the doctor. This helps prevent the growth of bacteria that may otherwise lead to skin infection.

3. Protect wounds and infections

Individuals with open wounds or skin infections should avoid hot tubs, swimming pools, and other water bodies such as lakes, rivers, and oceans. This also prevents them from bacterial skin infections. 

4. Maintain hand hygiene

Sometimes, unknown cuts can spread the infection to others. It is always advisable to wash your hands more often, especially after coughing and sneezing. Hand hygiene should also be maintained before preparing foods and during eating.

5. Maintain a healthy skin barrier

The skin barrier should be maintained through timely management of skin conditions such as atopic dermatitis and eczema. Any allergen or irritant to the skin should be avoided.  

6. Go for a skin examination

Individuals with diabetes or obesity should have their skin screened regularly. People with diabetes should also check their feet daily for signs of injury or infection. Early management can help prevent infection.

Specialist To Visit 

Bacterial skin infections require medical attention for accurate diagnosis. It's crucial that individuals showing any sign of infection refrain from relying on over-the-counter medication. Early intervention is essential in preventing any complications.  

When to see a doctor?

Immediate medical attention should be taken in case of the following symptoms:

• Spreading of rash to more than 10% of the body area

• Consistent high fever

• Severe pain at the infected site

• Spreading of redness and swelling 

• Joint and muscle pain

• Difficulty in swallowing 

• Trouble in falling asleep

Doctors who can help in the diagnosis and treatment of bacterial skin infections are:

• General physician

• Dermatologist

• Internal medicine specialist

A General Physician will examine the symptoms and initiate treatment.

Dermatologists can also be consulted as they specialize in diagnosing and treating skin disorders.

Internal medicine specialists provide comprehensive care for adult patients, manage complex cases, and address underlying health conditions.

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Treatment Of Bacterial skin infections

Before initiating treatment, the type of infection is determined through a physical examination and lab tests. While minor infections often resolve without medication, severe infections may require antibiotics. 

Treatment approaches

• The affected area should be kept clean

• Dressings should be applied as per the instructions

• Limbs should be kept elevated in case of infection in the arms to reduce swelling

• Drainage of the pus is also required in case of skin abscess

• The following topical and oral antibiotics are considered in case of severe infection

  • Fusidic acid

  • Cephalexin

  • Sulfamethoxazole + Trimethoprim

  • Clindamycin

  • Vancomycin

• Intravenous antibiotics (like Cefazolin) may be used in more serious infections.

Home-care For Bacterial skin infections

Some old-age home remedies can help in managing bacterial skin infections. However, make sure to consult your doctor before initiating any of these:

1. Turmeric (Haldi): Turmeric has antibacterial properties that heal infections. It can be applied to the affected area by mixing it with honey or water. 

2. Aloe vera: Aloe vera possess antibacterial and cooling properties. Its gel can be applied directly on the affected part of the skin. 

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3. Tea tree oil: This oil is known to possess antibacterial properties. A mixture of 2-3 drops of tea tree oil and 1 tablespoon of coconut oil can be applied to the infected area. It should be kept for 30 minutes and then washed off. 

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4. Fenugreek (Methi): This commonly used spice in Indian kitchens inhibits the growth of various staphylococcal bacteria. One teaspoon of fenugreek seeds can be boiled with water until they become soft. The extracted water can be applied to the infected part after cooling. 

5. Coconut oil: Due to its several medicinal properties, coconut oil is an excellent remedy for bacterial skin infections. 

6. Honey (Shehad): It has been known for years to heal wounds. Along with its antimicrobial properties, it also makes a protective coating around wounds. 

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Complications Of Bacterial skin infections

Bacterial skin infections are usually resolved with proper medical care. However, some severe or frequent recurrent infections may lead to: 

• Breakdown of skin

• Formation of abscess (pus)

• Sepsis (the body's extreme response to an infection characterized by loss of consciousness and severe breathlessness)

• Septic emboli (infected blood clots that arise from a site of infection)

• Postinflammatory hyperpigmentation (darkening of the skin)

• Rheumatic fever (swelling of the heart, joints, brain, and skin as a result of immune response)

• Osteomyelitis (bone infection)

• Endocarditis (swelling of the lining of the heart)

• Thrombophlebitis (swelling in a vein due to a blood clot)

• Bacteremia (spreading of the infection to the blood)

• Suppurative arthritis (bacterial infection in a joint)