Erysipeloid: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
Line 22: Line 22:
==Treatment==
==Treatment==
The treatment of choice is a single dose of [[Penicillin#Benzathine|benzathine benzylpenicillin]] given by [[intramuscular injection]], or a five-day to one-week course of either [[penicillin#Phenoxymethylpenicillin/penicillin V|oral penicillin]] or intramuscular [[procaine benzylpenicillin]].<ref name=POC-IT>{{cite web |url=http://prod.hopkins-abxguide.org/pathogens/bacteria/aerobic_gram_positive_bacillus/erysipelothrix_rhusiopathiae.html |title=''Erysipelothrix rhusiopathiae''  |author=Vinetz J |date=October 4, 2007 |work=Point-of-Care Information Technology ABX Guide |publisher=[[Johns Hopkins University]]}} Retrieved on October 28, 2008. Freely available with registration.</ref> [[Erythromycin]] or [[doxycycline]] may be given instead to people who are allergic to penicillin. ''E. rhusiopathiae'' is intrinsically [[antibiotic resistance|resistant]] to [[vancomycin]].<ref name=POC-IT/>
The treatment of choice is a single dose of [[Penicillin#Benzathine|benzathine benzylpenicillin]] given by [[intramuscular injection]], or a five-day to one-week course of either [[penicillin#Phenoxymethylpenicillin/penicillin V|oral penicillin]] or intramuscular [[procaine benzylpenicillin]].<ref name=POC-IT>{{cite web |url=http://prod.hopkins-abxguide.org/pathogens/bacteria/aerobic_gram_positive_bacillus/erysipelothrix_rhusiopathiae.html |title=''Erysipelothrix rhusiopathiae''  |author=Vinetz J |date=October 4, 2007 |work=Point-of-Care Information Technology ABX Guide |publisher=[[Johns Hopkins University]]}} Retrieved on October 28, 2008. Freely available with registration.</ref> [[Erythromycin]] or [[doxycycline]] may be given instead to people who are allergic to penicillin. ''E. rhusiopathiae'' is intrinsically [[antibiotic resistance|resistant]] to [[vancomycin]].<ref name=POC-IT/>
===Antimicrobial Regimen===
* Erysipelothrix rhusiopathiae <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*1. '''Erysipeloid of Rosenbach (localized cutaneous infection)'''
::* Preferred regimen (1): [[Penicillin G benzathine]] 1.2 MU IV single dose
::* Preferred regimen (2): [[Penicillin VK]] 250 mg PO qid for 5-7 days
::* Preferred regimen (3): [[Procaine penicillin]] 0.6-1.2 MU IM qd for 5-7 days
::* Alternative regimen (1): [[Erythromycin]] 250 mg PO qid for 5-7 days
::* Alternative regimen (2): [[Doxycycline]] 100 mg PO bid for 5-7 days
:*2. '''Diffuse cutaneous infection'''
::* Preferred regimen: See localized infection
:*3. '''Bacteremia or endocarditis'''
::* Preferred regimen: [[Penicillin G benzathine]] 2-4 MU IV q4h for 4-6 weeks
::* Alternative regimen (1): [[Ceftriaxone]] 2 g IV q24h for 4-6 weeks
::* Alternative regimen (2): [[Imipenem]] 500 mg IV q6h for 4-6 weeks
::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 4-6 weeks
::* Alternative regimen (4): [[Daptomycin]] 6 mg/kg IV q24h for 4-6 weeks
::* Note: Recommended duration of therapy for endocarditis is 4 to 6 weeks, although shorter courses consisting of 2 weeks of intravenous therapy followed by 2 to 4 weeks of oral therapy have been successful.


== See also ==
== See also ==

Revision as of 20:45, 5 August 2015

Erysipeloid
Cellular and colonial morphology of Erysipelothrix rhusiopathiae
ICD-10 A26
ICD-9 027.1
DiseasesDB 4432
MedlinePlus 000632
eMedicine derm/602 
MeSH D004887
This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Erysipelothrix rhusiopathiae.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In humans, Erysipelothrix rhusiopathiae infections most commonly present in a mild cutaneous form known as erysipeloid[1] or fish poisoning.[2] E. rhusiopathiae can cause an indolent cellulitis, more commonly in individuals who handle fish and raw meat.[3] It gains entry typically by abrasions in the hand. Bacteremia and endocarditis are uncommon but serious sequelae.[4][5] Due to the rarity of reported human cases, E. rhusiopathiae infections are frequently misidentified at presentation.[1]

Treatment

The treatment of choice is a single dose of benzathine benzylpenicillin given by intramuscular injection, or a five-day to one-week course of either oral penicillin or intramuscular procaine benzylpenicillin.[6] Erythromycin or doxycycline may be given instead to people who are allergic to penicillin. E. rhusiopathiae is intrinsically resistant to vancomycin.[6]

Antimicrobial Regimen

  • Erysipelothrix rhusiopathiae [7]
  • 1. Erysipeloid of Rosenbach (localized cutaneous infection)
  • 2. Diffuse cutaneous infection
  • Preferred regimen: See localized infection
  • 3. Bacteremia or endocarditis
  • Preferred regimen: Penicillin G benzathine 2-4 MU IV q4h for 4-6 weeks
  • Alternative regimen (1): Ceftriaxone 2 g IV q24h for 4-6 weeks
  • Alternative regimen (2): Imipenem 500 mg IV q6h for 4-6 weeks
  • Alternative regimen (3): Ciprofloxacin 400 mg IV q12h for 4-6 weeks
  • Alternative regimen (4): Daptomycin 6 mg/kg IV q24h for 4-6 weeks
  • Note: Recommended duration of therapy for endocarditis is 4 to 6 weeks, although shorter courses consisting of 2 weeks of intravenous therapy followed by 2 to 4 weeks of oral therapy have been successful.

See also

References

  1. 1.0 1.1 Brooke C, Riley T (1999). "Erysipelothrix rhusiopathiae: bacteriology, epidemiology and clinical manifestations of an occupational pathogen". J Med Microbiol. 48 (9): 789–99. doi:10.1099/00222615-48-9-789. PMID 10482289.
  2. "THE SHIP CAPTAIN'S MEDICAL GUIDE" (PDF). p. 190.
  3. Lehane L, Rawlin G (2000). "Topically acquired bacterial zoonoses from fish: a review". Med J Aust. 173 (5): 256–9. PMID 11130351.
  4. Brouqui P, Raoult D (2001). "Endocarditis due to rare and fastidious bacteria". Clin Microbiol Rev. 14 (1): 177–207. doi:10.1128/CMR.14.1.177-207.2001. PMC 88969. PMID 11148009.
  5. Nassar I, de la Llana R, Garrido P, Martinez-Sanz R (2005). "Mitro-aortic infective endocarditis produced by Erysipelothrix rhusiopathiae: case report and review of the literature". J Heart Valve Dis. 14 (3): 320–4. PMID 15974525.
  6. 6.0 6.1 Vinetz J (October 4, 2007). "Erysipelothrix rhusiopathiae". Point-of-Care Information Technology ABX Guide. Johns Hopkins University. Retrieved on October 28, 2008. Freely available with registration.
  7. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

Template:Cutaneous infections