Prognosis
Without treatment, individuals with impetigo typically get better within three weeks. Complications may include cellulitis or poststreptococcal glomerulonephritis. Rheumatic fever does not appear to be related. Epidemiology
Globally, impetigo affects more than 162 million children in low- to middle-income countries. The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania. The tropical climate and high population in lower socioeconomic regions contribute to these high rates. Children under the age of 4 in the United Kingdom are 2.8% more likely than average to contract impetigo; this decreases to 1.6% for children up to 15 years old. As age increases, the rate of impetigo declines, but all ages are still susceptible. History
Impetigo was originally described and differentiated by William Tilbury Fox around 1864. The word impetigo is the generic Latin word for skin eruption, and it stems from the verb impetere to attack (as in impetus). Before the discovery of antibiotics, the disease was treated with an application of the antiseptic gentian violet, which was an effective treatment. References
External links
Impetigo at Curlie
Impetigo and Ecthyma at Merck Manual of Diagnosis and Therapy Professional Edition
Treatment
Treatment for psychogenic polydipsia depends on severity and may involve behavioural and pharmacological modalities. Acute hyponatraemia
If the patient presents with acute hyponatraemia (overhydration) caused by psychogenic polydipsia, treatment usually involves administration of intravenous hypertonic (3%) saline until the serum sodium levels stabilise to within a normal range, even if the patient becomes asymptomatic. Fluid restriction
If the patient is institutionalised, monitoring of behaviour and serum sodium levels is necessary. In treatment-resistant polydipsic psychiatric patients, regulation in the inpatient setting can be accomplished by use of a weight-water protocol. First, base-line weights must be established and correlated to serum sodium levels. Weight will normally fluctuate during the day, but as the water intake of the polydipsic goes up, the weight will naturally rise. The physician can order a stepped series of interventions as the weight rises. The correlation must be individualized with attention paid to the patients normal weight and fluctuations, diet, comorbid disorders (such as a seizure disorder) and urinary system functioning. Progressive steps might include redirection, room restriction, and increasing levels of physical restraint with monitoring. Such plans should also include progressive increases in monitoring, as well as a level at which a serum sodium level is drawn. Behavioural
Behavioural treatments may involve the use of a token economy to provide positive reinforcement to desirable behaviour. Furthermore, cognitive therapy techniques can be used to address the thought patterns that lead to compulsive drinking behaviour. Success has been seen in trials of this technique, with emphasis on the development of coping techniques (e.g.