Impetigo in soldiers after hand-to-hand combat training

Bacterial skin infections are very common and trigger destruction of the skin integrity. Impetigo is a consequence of group A beta-hemolytic streptococcus or Staphylococcus aureus infection. The clinical presentation in general is very typical and empiric treatment is usually successful. In cases of close contacts such as between classmates, athletes, or soldiers, the prompt recognition and appropriate treatment of the infection may stop an epidemic. We report a group of six soldiers who shared the same military equipment (physical shields) during hand-to-hand combat training. All of the soldiers had skin lesions and two of them suffered from systemic symptoms. Group A beta-hemolytic streptococcus and S. aureus were cultured from the impetiginous lesions. All patients recovered after systemic and/or local antibiotic treatments. These cases emphasize the need for the maintenance of proper hygiene throughout the training program to prevent spread of the disease and the importance of rapid diagnosis by bacteriological identification.