A bacterial skin rash is a common condition characterized by the presence of an itchy and/or blistering rash. It can be caused by a variety of bacteria, including Strep A, which made headlines in February 2019 when an 11-year-old boy died from an invasive strep A infection after being injured at the gym.
What is Strep A?
Strep A (Group A streptococcal infections) typically causes mild illnesses such as tonsillitis, sore throat, or skin infections. But when the bacteria infects areas of the body that are usually sterile—like blood, deep muscles, fat, and the lungs—it can cause more severe invasive illnesses, including necrotizing fasciitis and streptococcal toxic shock syndrome, both of which are potentially deadly. The World Health Organization (WHO) issued a warning in December 2022 about a rise in severe strep A cases and deaths in many countries, including France, Ireland, the Netherlands, Sweden, the U.K., and Northern Ireland.
How is Strep A different than Mpox and Chickenpox?
Mpox and chickenpox are two contagious viral diseases. They both have pox in their names because they cause pockmark skin lesions. But mpox is caused by a virus similar to smallpox, while a type of herpesvirus causes chickenpox. While they share similar symptoms , mpox and chickenpox differ by how the viruses are spread, the locations of the rashes, the populations they most commonly affect, and how each is treated.
Symptoms
No less than three dozen viral diseases have pox in their names, the most familiar of which are chickenpox, smallpox, and mpox. All of these diseases share an itchy, blistering rash. Mpox and chickenpox progress in a similar way. Flu-like symptoms, such as headache, fever, and fatigue, precede the outbreak of the rash. These are referred to as prodromal symptoms. Within days, a rash will appear as small dots or pimples that quickly enlarge and fill with a clear or yellowish fluid. This blistering rash, typically itchy and sometimes painful, erupts, scabs over, and begins to heal.
Asymptomatic infection
Studies reveal that around 1 in 14 people with mpox are asymptomatic, meaning that they have no symptoms but can still transmit the disease. Asymptomatic infections may also occur with chickenpox. In contrast, strep A infections are rarely asymptomatic.
Diagnosis and treatment
If you suspect you may have a bacterial skin rash, it’s important to seek medical advice for proper diagnosis. Tests such as Gram staining and cultures may be used for identification of bacteria causing the infection, if it is bacterial in origin. Depending on the type of bacteria, antibiotics may be prescribed for treatment. If the rash is due to a virus, antiviral medications may be recommended.
Antimicrobial susceptibility
For bacterial skin rashes, it is important to know the antimicrobial susceptibility of the bacteria causing the infection. Resistance to penicillins, aminoglycosides, macrolides, quinolones, sulfamethoxazole/trimethoprim, and fosfomycin have been reported. Strep A has not yet been found to be resistant to β-lactamase-containing penicillin, carbapenems, and cephems.
Prevention
In order to prevent bacterial skin rashes, it is important to take precautions to avoid coming into contact with someone who may be infected. You should also practice good hygiene, such as washing your hands often, avoiding sharing items such as towels and eating utensils, and regularly cleaning surfaces with disinfectants. If you have any open wounds or cuts, keep them clean and covered until healed.
Bacterial skin rashes can range from mild to very serious. It is important to recognize the signs and symptoms of a bacterial skin rash and seek medical advice if you think you may have one. Proper diagnosis and treatment of a bacterial skin rash is essential in order to prevent further complications. Taking preventive steps to limit the spread of infection and practicing good hygiene is the best way to protect yourself from contracting a bacterial skin rash.
