Erysipelas overview: Difference between revisions
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==Overview== | ==Overview== | ||
'''Erysipelas''' ([[Greek language|Greek]] ερυσίπελας - ''red skin'') is an acute [[streptococcus]] [[bacteria|bacterial]] infection of the [[dermis]], resulting in inflammation and characteristically extending into underlying fat tissue. | '''Erysipelas''' ([[Greek language|Greek]] ερυσίπελας - ''red skin'') is an acute [[streptococcus]] [[bacteria|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]].) | (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]].) | ||
==Pathophysiology== | |||
Historically, the face was most affected; today the legs are affected most often. <ref>See eMedicine link</ref> 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. | |||
==Causes== | |||
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. | |||
==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 [[lymph node|lymph]]atic drainage (e.g., after [[mastectomy]], pelvic surgery, [[Bypass (surgical)|bypass]] grafting) are also at increased risk. | |||
==Diagnosis== | |||
==History and Symptoms== | |||
Patients typically develop symptoms including high [[fevers]], [[tremor|shaking]], [[chills]], [[fatigue (physical)|fatigue]], [[headaches]], [[vomiting]], and general illness within 48 hours of the initial infection. The erythematous skin lesion develops which enlarges rapidly. More severe infections can result in[[vesicles]],[[blister|bullae]], and [[petechiae]], with possible skin [[necrosis]]. | |||
==Physical Examination== | |||
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]], [[blister|bullae]], and [[petechiae]], with possible skin [[necrosis]]. [[Lymph node]]s 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]]). | |||
==Treatment== | |||
===Medical Therapy=== | |||
Depending on the severity, treatment involves either oral or intravenous antibiotics, using [[penicillin]]s, clindamycin or [[erythromycin]]. While illness symptoms resolve in a day or two, the skin may take weeks to return to normal. | |||
==References== | ==References== | ||
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[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 21:19, 5 December 2012
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Erysipelas Microchapters |
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Diagnosis |
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Erysipelas overview On the Web |
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American Roentgen Ray Society Images of Erysipelas overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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.)
Pathophysiology
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.
Causes
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.
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.
Diagnosis
History 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 develops which enlarges rapidly. More severe infections can result invesicles,bullae, and petechiae, with possible skin necrosis.
Physical Examination
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).
Treatment
Medical Therapy
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.
References
- ↑ See eMedicine link