erysipelas

Erysipelas: A Common Bacterial Infection of the Skin

Erysipelas is a bacterial infection that affects the upper layer of the skin, known as the dermis, and the lymphatic vessels [1]. It is a superficial form of cellulitis, which is a potentially serious bacterial infection affecting the skin [2].

Characteristics of Erysipelas

• Erysipelas only affects the outermost layer of the skin and the local lymph nodes [3].
• It is a type of superficial cellulitis with dermal lymphatic involvement [4].
• The infection typically affects the lower limbs and the face, although it can occur on other parts of the body as well [5].

Causes and Symptoms

• Erysipelas is caused by bacterial infections, most commonly streptococcus [6].
• The symptoms of erysipelas include redness, swelling, and warmth in the affected area, which can be accompanied by fever and chills [7].

Treatment and Diagnosis

• Erysipelas is typically diagnosed clinically, meaning that it is identified based on its characteristic symptoms.
• Treatment for erysipelas usually involves oral or parenteral antibiotics to combat the bacterial infection [4].
• In some cases, hospitalization may be necessary if the infection is severe or widespread.

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 8 [6] Context result 9 [7] Context result 1

Erysipelas Signs and Symptoms

Erysipelas is a type of skin infection that can cause a range of symptoms, from mild to severe. The following are the common signs and symptoms of erysipelas:

• Fever and chills: A high temperature and feeling cold or shivery are often the first signs of erysipelas [1].
• Skin sore with a sharp raised border: As the infection spreads, a painful, red, swollen, and warm skin sore develops, typically on the face or legs [3].
• Blisters on the skin: In some cases, blisters may form on the affected area [1].
• Fiery red rash: A bright red rash can appear on the face and legs, accompanied by swelling and warmth in the affected area [4][7].
• Intense pain associated with the rash: The rash is often very painful to touch or move around [4][7].
• Fevers, chills, shivering, and high temperature: These symptoms can occur abruptly and are often accompanied by a fever [5][6].

Common Complications

If left untreated, erysipelas can lead to more serious complications, including:

• Abscess: A pocket of pus can form under the skin.
• Gangrene: In severe cases, the infection can cause tissue death (gangrene).
• Thrombophlebitis: Blood clots can form in the veins.

It's essential to seek medical attention if you suspect you have erysipelas. Early treatment can help prevent complications and promote a faster recovery.

References: [1] Symptoms · Fever and chills · Skin sore with a sharp raised border. [3] Jun 18, 2017 — Symptoms can include fevers, chills, shivering, and high temperature. [4] What are the Symptoms of Erysipelas? · Fiery red rash on the face and legs. · Swelling and warmth in the affected area. · Intense pain associated with the rash. [5] Symptoms and signs of erysipelas are usually abrupt in onset and often accompanied by fevers, chills and shivering. [6] In most cases, a person with erysipelas feels unwell or ill before noticing any visible signs of the condition appearing on the skin. Some common symptoms ... [7] What are the Symptoms of Erysipelas? · Fiery red rash on the face and legs. · Swelling and warmth in the affected area. · Intense pain associated with the rash. [8] Jun 19, 2020 — The most common complications of erysipelas include abscess, gangrene, and thrombophlebitis.

Diagnostic Tests for Erysipelas

Erysipelas, a type of bacterial skin infection, can be diagnosed through various methods. Here are some of the diagnostic tests used to confirm the condition:

• Visual Examination: The most common method of diagnosis is by visual examination of the affected area. Doctors look for characteristic symptoms such as raised red patches or blisters on the skin.
• Blood Culture: In some cases, doctors may send blood samples to a laboratory to identify the causative organism. This test can help confirm the presence of bacteria and guide antibiotic treatment.
• White Blood Cell Count (WBC): An elevated WBC count can indicate an infection, including erysipelas.
• C-Reactive Protein (CRP) Test: A CRP test measures the level of a protein in the blood that increases when there is inflammation or infection. Elevated levels can suggest erysipelas.
• Bacterial Skin Culture: This test involves taking a sample from the affected area and sending it to a laboratory for analysis. It can help identify the specific bacteria causing the infection.

According to [1], doctors may carry out a blood culture in toxic-appearing patients to confirm the diagnosis of erysipelas. Additionally, [3] states that a positive blood culture identifying the organism is one of the diagnostic criteria for erysipelas.

In some cases, other tests such as a biopsy or imaging studies may be performed to rule out other conditions or to assess the severity of the infection. However, these are not typically used for the initial diagnosis of erysipelas.

References: [1] Jun 19, 2020 — In classic erysipelas, no laboratory workup is required for diagnosis or treatment. However, leukocytosis and elevations in erythrocyte ... [3] How is erysipelas diagnosed? · Raised white cell count · Raised C-reactive protein · Positive blood culture identifying the organism. [5] Doctors base the diagnosis of erysipelas on the characteristic appearance of the patch. Sometimes doctors send blood samples to a laboratory to identify the ...

Treatment Options for Erysipelas

Erysipelas, a type of superficial cellulitis, can be effectively treated with antibiotics. The primary goal of treatment is to eliminate the infection and alleviate symptoms.

• Antibiotic Therapy: Oral or parenteral antibiotics are commonly prescribed to treat erysipelas. Penicillin is often used as a first-line treatment option [2][4]. Erythromycin may also be considered as an alternative to penicillin [9].
• Adjunctive Therapies: In addition to antibiotic therapy, other treatments such as bed rest, elevation of the affected area, and pain management may be recommended [6].

Long-term Preventive Treatment

For patients who experience recurrent attacks of erysipelas, long-term preventive treatment with penicillin is often required. This can help prevent future episodes of the infection [4].

Severity-Dependent Treatment

The severity of the infection determines whether oral or intravenous antibiotics are used. In severe cases, intravenous antibiotics such as vancomycin may be necessary, especially for facial erysipelas caused by MRSA [9].

References: [1] Not applicable [2] Context 2 [3] Not applicable [4] Context 4 [5] Not applicable [6] Context 6 [7] Not applicable [8] Context 8 [9] Context 9

Differential Diagnosis of Erysipelas

Erysipelas, a superficial form of cellulitis, requires accurate diagnosis to differentiate it from other skin conditions. The differential diagnosis of erysipelasis includes:

• Contact dermatitis: A skin reaction caused by exposure to an allergen or irritant, which can present with similar symptoms to erysipelas.
• Gravitational dermatitis (stasis dermatitis): A condition characterized by skin changes and inflammation in the lower extremities due to venous insufficiency.
• Vasculitis: Inflammation of blood vessels that can cause skin lesions, which may be mistaken for erysipelas.
• Thrombophlebitis (superficial thrombophlebitis): Inflammation of a vein caused by a blood clot, which can present with similar symptoms to erysipelas.
• Deep venous thrombosis: A blood clot in the deep veins that can cause skin changes and inflammation.

Additionally, other conditions such as:

• Noninfectious folliculitis
• Acne vulgaris (common acne)
• Acne rosacea
• Milia (small white bumps on the skin)
• Acneiform eruptions (skin lesions resembling acne)
• Dermatologic manifestations of renal diseases
• Cutaneous candidiasis (fungal infection of the skin)
• Coccidioidomycosis (fungal infection caused by Coccidioides immitis)

should be considered in the differential diagnosis of erysipelas.

According to [1], the differential diagnosis of erysipelasis is limited, and early on, the lesions of facial herpes zoster, contact dermatitis, or giant urticaria may be confused with erysipelas. [2] also mentions that assessing a patient for any recent skin trauma or pharyngitis is important in diagnosing erysipelas.

References:

[1] Vaillant L (2001) Diagnosis of erysipelas is based upon the association of an acute inflammatory plaque with fever, lymphagiitis, adenopathy and hyperleukocytosis. [2] Erysipelas remains a clinical diagnosis, and assessing a patient for any recent skin trauma or pharyngitis is important.