Erysipelas

Erysipelas
ICD-10	A46.0
ICD-9	035
DiseasesDB	4428
MedlinePlus	000618
eMedicine	derm/129

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

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.

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.

External links

• Erysipelas Overview Health in Plain English - with pictures

Template:Bacterial diseases
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