Intertrigo – Group A Strep Infection

 

 

 

 

 

 

We are all familiar with the issues that surround the febrile infant and the appropriate work-up. Often our familiarity can lead to complacency. One area that we need to remain vigilant is in performing a thorough physical exam. On occasion, the answer that we are looking for is right on the surface.

  • Intertrigo is a superficial cellulitis that localizes to intertriginous folds; folds, which are common in young infants (as well as patients of any age with generous sub-Q tissue).
    • Because of large heads and decreased muscle tone, infants have deep neck folds.
    • Those “well-feed” infants may have redundant folds in the axillae, groin, and leg regions.
    • Opposing sides of these folds become macerated because of fiction and become a portal of entry for skin flora.
  • Group A Beta-Hemolytic Strep may cause Intertrigo and the child may present with fussiness and low-grade fevers.
  • Many times this area has already been treated with a variety of topical ointments and creams (including anti-fungals).
  • The deep area of the fold will have a beefy-red, denuded appearance without satellite lesions.
  • Treated with 10-day course of oral penicillin or 1st Gen. Cephalosporin.
  • A neonate, however, deserves more conservative management.Honig, PJ. The great masqueraders: skin disorders that fool the eye. Contemp Pediatr. 1991; 8:98-109

Sean Fox

I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. I trained at the Combined Emergency Medicine and Pediatrics residency program at University of Maryland, where I had the tremendous fortune of learning from world renown educators and clinicians. Now I have the unbelievable honor of working with an unbelievably gifted group of practitioners at Carolinas Medical Center. I strive every day to inspire my residents as much as they inspire me.

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7 Responses

  1. Chany k. says:

    My daughter 3 months in age,suffers from intertrigo. I apply bactroban and nystatin. It disappears on one area then shows up on other spot… Is there an inside infection going on that just pops rashes out for prove? Does she need oral medication ? Acidafilus (dunno spelling) needed?

    • Sean Fox says:

      Thank you for your comment. Obviously, I am unable to give specific medical guidance over the internet. I would encourage you to see your child’s primary care provider to have the condition reassessed. There are many conditions that can cause skin findings similar to intertrigo. Intertrigo can also reoccur and its recurrence does not necessarily point toward a more serious underlying medical condition.

      Thank you,
      sean

      • Chany k. says:

        My Dr.diagnosed it as atopic dermatitis. From all pics I see online it looks exactly like intertrigo. How long does that usually last on babies? Also is there a way to prevent it from coming back?

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