Erysipelas
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| Erysipelas Classification and external resources | |
| ICD-10 | A46.0 |
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| ICD-9 | 035 |
| DiseasesDB | 4428 |
| MedlinePlus | 000618 |
| eMedicine | derm/129 |
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Erysipelas (Greek ερυσίπελας - red skin) is an acute streptococcus bacterial infection of the dermis, resulting in inflammation and characteristically extending into underlying fat tissue.
(Erysipelas is also the name given to an infection in animals caused by the bacterium Erysipelothrix rhusiopathiae. Infection by Erysipelothrix rhusiopathiae in humans is known as erysipeloid.)
Risk factors
This disease is most common among the elderly, infants, and children. People with immune deficiency, diabetes, alcoholism, skin ulceration, fungal infections and impaired lymphatic drainage (e.g., after mastectomy, pelvic surgery, bypass grafting) are also at increased risk.
Signs and symptoms
Patients typically develop symptoms including high fevers, shaking, chills, fatigue, headaches, vomiting, and general illness within 48 hours of the initial infection. The erythematous skin lesion enlarges rapidly and has a sharply demarcated raised edge. It appears as a red, swollen, warm, hardened and painful rash, similar in consistency to an orange peel. More severe infections can result in vesicles, bullae, and petechiae, with possible skin necrosis. Lymph nodes may be swollen, and lymphedema may occur. Occasionally, a red streak extending to the lymph node can be seen.
The infection may occur on any part of the skin including the face, arms, fingers, legs and toes, but it tends to favor the extremities. Fat tissue is most susceptible to infection, and facial areas typically around the eyes, ears, and cheeks. Repeated infection of the extremities can lead to chronic swelling (lymphadenitis).
Etiology
Most cases of erysipelas are due to Streptococcus pyogenes (also known as group A streptococci), although non-group A streptococci can also be the causative agent. Historically, the face was most affected; today the legs are affected most often. [1]
Erysipelas infections can enter the skin through minor trauma, eczema, surgical incisions and ulcers, and often originate from strep bacteria in the subject's own nasal passages.
Diagnosis
This disease is mainly diagnosed by the appearance of the rash and its characteristics. Blood cultures are unreliable for diagnosis of the disease, but may be used to test for sepsis. Erysipelas must be differentiated from herpes zoster, angioedema, contact dermatitis, and diffuse inflammatory carcinoma of the breast.
Erysipelas can be distinguished from cellulitis by its raised advancing edges and sharp borders. Elevation of the antistreptolysin O titre occurs after around 10 days of illness.
Treatment
Depending on the severity, treatment involves either oral or intravenous antibiotics, using penicillins, clindamycin or erythromycin. While illness symptoms resolve in a day or two, the skin may take weeks to return to normal.
Complications
- Spread of infection to other areas of body through the bloodstream (bacteremia), including septic arthritis and infective endocarditis (heart valves).
- Septic shock.
- Recurrence of infection – Erysipelas can recur in 18-30% of cases even after antibiotic treatment.
- Lymphatic damage
- Necrotizing fasciitis -- AKA "the flesh-eating bug." A potentially-deadly exacerbation of the infection if it spreads to deeper tissue.
Footnotes
External links
- Erysipelas Overview Health in Plain English - with pictures
cs:Erysipel
de:Erysipeleo:Erizipelo
fr:Érysipèle
it:Erisipela
lt:Rožė (liga)
nl:Erysipelas
no:Erysipelasfi:Ruusu (sairaus)
sv:Rosfeber
WikiDoc Research Resources for Erysipelas | |
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| Articles on Erysipelas | Most recent articles on Erysipelas • Most cited articles on Erysipelas • Review articles on Erysipelas • Articles on Erysipelas in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Erysipelas | Powerpoint slides on Erysipelas • Images of Erysipelas • Photos of Erysipelas • Podcasts & MP3s on Erysipelas • Videos on Erysipelas |
| Evidence Based Medicine Regarding Erysipelas | Cochrane Collaboration on Erysipelas • Bandolier on Erysipelas • TRIP on Erysipelas |
| Cost Effectiveness of Erysipelas | Cost Effectiveness of Erysipelas |
| Clinical Trials Involving Erysipelas | Ongoing Trials on Erysipelas at Clinical Trials.gov • Trial results on Erysipelas • Clinical Trials on Erysipelas at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Erysipelas | US National Guidelines Clearinghouse on Erysipelas • NICE Guidance on Erysipelas • NHS PRODIGY Guidance • FDA on Erysipelas • CDC on Erysipelas |
| Textbook Information on Erysipelas | Books and Textbook Information on Erysipelas |
| Pharmacology Resources on Erysipelas | Dosing of Erysipelas • Drug interactions with Erysipelas • Side effects of Erysipelas • Allergic reactions to Erysipelas • Overdose information on Erysipelas • Carcinogenicity information on Erysipelas • Erysipelas in pregnancy • Pharmacokinetics of Erysipelas • |
| Genetics, Pharmacogenomics, and Proteinomics of Erysipelas | Genetics of Erysipelas • Pharmacogenomics of Erysipelas • Proteomics of Erysipelas |
| Newstories on Erysipelas | Erysipelas in the news • Be alerted to news on Erysipelas • News trends on Erysipelas |
| Commentary on Erysipelas | Blogs on Erysipelas |
| Patient Resources on Erysipelas | Patient resources on Erysipelas • Discussion groups on Erysipelas • Patient Handouts on Erysipelas • Directions to Hospitals Treating Erysipelas • Risk calculators and risk factors for Erysipelas |
| Healthcare Provider Resources on Erysipelas | Symptoms of Erysipelas • Causes & Risk Factors for Erysipelas • Diagnostic studies for Erysipelas • Treatment of Erysipelas |
| Continuing Medical Education (CME) Programs on Erysipelas | CME Programs on Erysipelas |
| International Resources on Erysipelas | Erysipelas en Espanol • Erysipelas en Francais |
| Business Resources on Erysipelas | Erysipelas in the Marketplace • Patents on Erysipelas |
| Informatics Resources on Erysipelas | List of terms related to Erysipelas |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
