2what is erysipelas ?It is a streptococcal infection of the superficial lymphatic vessels, usually associated with broken skin on the face.The area affected is erythematous and oedematous.The patient may be febrile and have a leucocytosis.
7In erysipelas, the infection rapidly invades and spreads through the lymphatic vessels. This can produce overlying skin "streaking" and regional lymph node swelling and tenderness. Immunity does not develop to the inciting organism.
22causesStreptococcal toxins are thought to contribute to the brisk inflammation that is pathognomonic of this infection.they clearly coexist with streptococci at sites of inoculation.
23Recently, atypical forms reported to be caused by : * Streptococcus pneumoniae,*Klebsiella pneumoniae,* Haemophilus influenzae,*Yersinia enterocolitica,*Moraxella species,
24Causative agent * Streptococci are the primary cause of erysipelas. * Most facial infections are attributed to group A streptococci,*lower extremity infections being caused by non–group A streptococci.
28symptoms Blisters Fever, shaking, and chills Painful, very red, swollen, and warm skin underneath the sore (lesion)Skin lesion with a raised borderSores (erysipelas lesions) on the cheeks and bridge of the nose
45* acute bacterial infection of traumatized skin. * caused by Erysipelothrix rhusiopathiae (gram positive rod-shaped bacterium), which cause animal and human infections.* Direct contact between infected meat and traumatized human skin results in Erysipeloid.more common among farmers, butchers, cooks, homemakers.* Lesions most commonly affect the hands.
47Antibiotics such as penicillin are used to eliminate the infection Antibiotics such as penicillin are used to eliminate the infection. In severe cases, antibiotics may need to be given through an IV (intravenous line).Those who have repeated episodes of erysipelas may need long-term antibiotics.
48Medical care* Elevation and rest of the affected limb are recommended to reduce local swelling, inflammation, and pain.* Saline wet dressings should be applied to ulcerated and necrotic lesions and changed every 2-12 hours, depending on the severity of the infection.
49*A first-generation cephalosporin or macrolide, such as erythromycin or azithromycin, may be used if the patient has an allergy to penicillin.
50Two new drugs:roxithromycin & pristinamycin,have been reported to be extremely effective in the treatment of erysipelas.
51Expectation ( prognosis) With treatment, the outcome is good. It may take a few weeks for the skin to return to normal. Peeling is common.
52complicationsIn some patients, the bacteria may travel to the blood. This results in a condition called bacteremia. The infection may spread to the heart valves, joints, and bones.Other complications include:Return of infectionSeptic shock
54Recurrent erysipealsPatients with recurrent erysipelas should be educated regarding :local antisepstic .general wound care.Predisposing lower extremity skin lesions (eg , tineapedis , toe web intertrigo , stasis ulcers) should be treated aggressively to prevent super-infection.
55preventionKeep your skin healthy by avoiding dry skin and preventing cuts and scrapes. This may reduce the risk for erysipelas.
56activityPatients with acute infections involving the extremities should be encouraged to limit their activity and keep the limb elevated to decrease swelling.