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
• Liquid discharge from a wound
• Swelling of lymph nodes

Erythema may not be very visible in individuals with a darker skin tone. Some bacterial skin infections can progress rapidly. Severe infections may also lead to:

• Fever
• Chills
• Increased heart rate
• Altered mental status
• Blisters on the skin filled with clear fluid
• Crepitus (unusual crackling sensation while palpating the skin)

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

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

1. Injuries Skin injuries permit bacteria to enter deeper tissues through skin breaks. These injuries can result from:
• 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, making it prone to bacterial growth, which may lead to infection.
5. Edema Persistent swelling, especially in the arms and legs, can crack the skin, allowing bacteria to enter beneath the surface and cause a skin infection.
6. Diabetes Complications of diabetes can lead to cracks in the superficial layer of the skin and skin breakdown, increasing the chances of bacterial skin infection. Commonly observed bacterial skin infections in diabetics include cellulitis, folliculitis, impetigo, carbuncle, and furuncle.
7. Low Immunity Individuals with low immunity are at higher risk of bacterial skin infections. This includes:
• Elderly people
• Individuals undergoing chemotherapy
• Individuals taking medications that suppress the immune system
• People with Human Immunodeficiency Virus (HIV) infection

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:

• 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.
  • 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: This 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.
• Skin culture: This 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 appropriate treatment plan.

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

1. Take proper care of the wounds
   Wounds are the leading cause of infection. Proper care of wounds and injuries can help prevent bacterial skin infections. The following measures should be taken to keep wounds free from bacteria:
   • Wash hands with soap and water frequently.
   • Use an alcohol-based hand rub if washing is not possible.
   • Keep draining or open wounds clean.
   • Cover wounds and injuries with dressings until they heal.
2. Do not ignore any break in the skin
   Any puncture or break in the skin should not be ignored. It should be consulted with a doctor immediately to prevent the growth of bacteria that may lead to skin infections.
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 to prevent bacterial skin infections.
4. Maintain hand hygiene
   Unknown cuts can spread infections to others. It is advisable to wash hands frequently, especially after coughing and sneezing. Hand hygiene should also be maintained before preparing food and during meals.
5. Maintain a healthy skin barrier
   The skin barrier should be maintained through timely management of skin conditions such as atopic dermatitis and eczema. Avoid any allergens or irritants to the skin.
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.

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 required in case of a skin abscess.

The following topical and oral antibiotics are considered in cases of severe infection:

• Fusidic acid
• Cephalexin
• Sulfamethoxazole + Trimethoprim
• Clindamycin
• Vancomycin

Intravenous antibiotics (such as Cefazolin) may be used in more serious 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:

• Turmeric (Haldi): Turmeric has antibacterial properties that aid in healing infections. It can be applied to the affected area by mixing it with honey or water.
• Aloe Vera: Aloe vera possesses antibacterial and cooling properties. Its gel can be applied directly to the affected part of the skin.
• Tea Tree Oil: This oil is known for its 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 left on for 30 minutes and then washed off.
• 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 area after cooling.
• Coconut Oil: Due to its numerous medicinal properties, coconut oil is an excellent remedy for bacterial skin infections.
• Honey (Shehad): Honey has been known for years to heal wounds. Along with its antimicrobial properties, it also forms a protective coating around wounds.

Bacterial skin infections are usually resolved with proper medical care. However, some severe or frequently 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)