Erysipelas St. Anthony’s fire/ Ignis Sacer Acute beta hemolytic group A Streptococcal infection Predisposing factors: Any break in the skin Involves superficial dermal lymphatics Local redness, heat, swelling, raised, indurated border Prodromal symptoms: Malaise, chills, high fever, headache, vomiting, and joint pains

Erysipelas PMN lekocytosis: 20,000/cu. mm or more Skin lesions may vary from transient hyperemia, followed by slight desquamation to intense inflammation with vesiculation and phlegmon Eruption begins at 1 point as an erythematous patch and spreads by peripheral extension

Erysipelas Advancing edge Raised and sharply demarcated Vesicles or bullae may contain seropurulent May result to gangrene Most frequently affected sites: Face and Neck Face: begins on the cheek near the nose or in front of the lobe of the ear and spreads toward the scalp Complications: Septicemia, Deep cellulitis

Erysipelas

Cellulitis Suppurative inflammation involving the subcutaneous tissue Streptococcus pyogenes Children, Immunocompromised: Increased risk for severe complications Hematologic malignancy, DM, IV drug abuse, Cardiovascular disorders

Onset: Mild local erythema and tenderness, malaise, and chilly sensations, or a sudden chill and fever Erythema rapidly becomes intense and spreads Infiltrated and pits on pressure

Central part becomes nodular Surmounted by a vesicle that ruptures and discharges pus and necrotic material Lymphangitis may spread to neighboring lymph glands Gangrene, metastatic abscess, grave sepsis (Rare)

Cellulitis