Erysipelas on surgical scar: a case report (original) (raw)
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Erysipelas, a large retrospective study of aetiology and clinical presentation
BMC Infectious Diseases, 2015
Background: Erysipelas is a common and severe infection where the aetiology and optimal management is not well-studied. Here, we investigate the clinical features, bacteriological aetiology, and treatment of erysipelas. Methods: Episodes of erysipelas in a seven-years period in our institution were studied retrospectively using a pre-specified protocol and is presented with descriptive and comparative statistics. Results: 1142 episodes of erysipelas were identified in 981 patients. Patients had a median age of 61 years, 59 % were male, a majority had underlying diseases or predisposing conditions, and the leg was most often affected. Wound cultures were taken in 343 episodes and 56 grew group A streptococci (GAS), 53 grew group G streptococci (GGS), 11 grew group C streptococci (GCS), and 153 grew Staphylococcus aureus. Blood cultures were drawn in 49 % of episodes and 50 cultures were positive with GGS as the most common finding (21 cultures) followed by GAS in 13, group B streptococci in 5, S. aureus in 4, and GCS in 3 cultures. In 45 % of episodes, patients received antibiotics with activity against S. aureus. Conclusions: GGS is the most common streptococcus isolated in erysipelas and the role of S. aureus in erysipelas remains elusive.
Blistering erysipelas, a common disease, is reported very less from Indian subcontinent. Most common sites involved are lower limb followed by face and trunk. In literature, erysipelas of upper limb is reported only in breast carcinoma patients who have received radiotherapy following mastectomy. We report a case of blistering erysipelas of upper limb in an elderly male following an insect bite. To best of our knowledge, this is the first case of its kind being reported from Himalyan region of Uttarakhand in India. This description seeks to emphasize the main risk factors and predisposing factors, in addition to some atypical features and current challenges involved in the differential diagnosis for erysipelas.
Facial Erysipelas: A Case Report
Integrative Journal of Medical Sciences, 2020
Erysipelas is a superficial cutaneous process that is usually restricted to the dermis, but with prominent lymphatic involvement commonly caused by streptococci. We present a patient who was admitted for swelling and erythema of his left cheek. We diagnosed facial erysipelas, the curative treatment was based on the prescription of effective antibiotic therapy against streptococci and bacteria producing β-lactamase (staphylococci). Removal of the remaining teeth was scheduled during medical treatment. At a 4-month follow-up after dental removal, there has been no recurrence of erysipelas.Through a clinical case of facial erysipelas, this work allows illustrating the specificities of this pathology.
Antibiotic use in patients with erysipelas: a retrospective study
The Israel Medical Association journal : IMAJ, 2001
BACKGROUND Erysipelas is a skin infection generally caused by group A streptococci. Although penicillin is the drug of choice, some physicians tend to treat erysipelas with antibiotics other than penicillin. OBJECTIVES To define the pattern of antibiotic use, factors affecting antibiotic selection, and outcome of patients treated with penicillin versus those treated with other antimicrobial agents. METHODS A retrospective review of charts of adult patients with discharge diagnosis of erysipelas was conducted for the years 1993-1996. RESULTS The study group comprised 365 patients (median age 67 years). In 76% of the cases infection involved the leg/s. Predisposing condition/s were present in 82% of cases. Microorganisms were isolated from blood cultures in only 6 of 176 cases (3%), and Streptococcus spp. was recovered in four of these six patients. Cultures from skin specimens were positive in 3 of 23 cases. Penicillin alone was given to 164 patients (45%). Other antibiotics were mor...
Bullous erysipelas: A retrospective study of 26 patients
Journal of the American Academy of Dermatology, 1999
E rysipelas is a superficial form of cellulitis caused by a variety of microbes; it responds to antibiotic treatment. The typical clinical presentation includes leg tenderness, sharply demarcated erythema, and edema. Lymphangitis and inguinal lymphadenopathy may be present, and the onset is usually accompanied by fever and sometimes shivering. 1 During the past few years we have treated several patients with a bullous form of erysipelas involving the lower legs. We believe they had a more protracted course of the disease than did patients with nonbullous erysipelas. This is a retrospective study of 26 patients with bullous erysipelas of the legs treated by the authors over a 5-year period.
Clinical and Experimental Dermatology, 2009
Erysipeloid is an occupational infection of the skin caused by traumatic penetration of Erysipelothrix rhusiopathiae. The disease is characterized clinically by an erythematous oedema, with well-defined and raised borders, usually localized to the back of one hand and ⁄ or fingers. Vesicular, bullous and erosive lesions may also be present. The lesion may be asymptomatic or accompanied by mild pruritus, pain and fever. In addition to cutaneous infection, E. rhusiopathiae can cause endocarditis, which may be acute or subacute. Endocarditis is rare and has a male predilection. It usually occurs in previously damaged valves, predominantly the aortic valve. Endocarditis does not occur in patients with valvular prostheses and is not associated with intravenous drug misuse. Diagnosis of localized erysipeloid is based on the patient's history (occupation, previous traumatic contact with infected animals or their meat) and clinical picture (typical skin lesions, lack of severe systemic features, slight laboratory abnormalities and rapid remission after treatment with penicillin or cephalosporin).
Colonization of β-hemolytic streptococci in patients with erysipelas—a prospective study
European Journal of Clinical Microbiology & Infectious Diseases
Erysipelas is a common skin infection causing significant morbidity. At present there are no established procedures for bacteriological sampling. Here we investigate the possibility of using cultures for diagnostic purposes by determining the perianal colonization with beta-hemolytic streptococci (BHS) in patients with erysipelas. Patients with erysipelas and a control group of patients with fever without signs of skin infection were prospectively included and cultures for BHS were taken from the tonsils, the perianal area, and wounds. BHS were grouped according to Lancefield antigen, species-determined, and emm-typed. Renewed cultures were taken after four weeks from patients with erysipelas and a positive culture for BHS. 25 patients with erysipelas and 25 with fever were included. In the group with erysipelas, 11 patients (44%) were colonized with BHS, ten patients were colonized in the perianal area, and one patient in the throat. In contrast, only one patient in the control group was colonized (p = 0.005 for difference). All of the patients with erysipelas colonized with BHS had an erythema located to the lower limb. The BHS were then subjected to MALDI-TOF MS and most commonly found to be Streptococcus dysgalactiae. Renewed cultures were taken from nine of the 11 patients with BHS and three of these were still colonized. Streptococcus dysgalactiae colonizes the perianal area in a substantial proportion of patients with erysipelas. The possibility of using cultures from this area as a diagnostic method in patients with erysipelas seems promising.
Child Erysipelas: About 16 Pediatric Cases Case Report
Erysipelas is an acute or sub-acute non necrotizing bacterial dermo-hypodermitis , caused most frequently by beta-hemolytic group A streptococci. It is a relatively frequent pathology in adults and the elderly, but rare in children and infants. Through the analysis of 16 cases of pediatric erysipelas we evaluate the epidemiological, clinico-biological, therapeutic and outcomes characteristics of erysipelas in children and infants.
Wolf in sheep's clothing: a case of carcinoma erysipeloides
Oxford medical case reports, 2016
Cutaneous metastases of the breast carcinomas can present clinically as nodules, plaques and tumors (most commonly as nodules) as well as 'erysipelas-like' lesions are known as 'carcinoma erysipeloides'. We want to share our experience in diagnosing a middle-aged lady with carcinoma erysipeloides secondary to breast carcinoma and her management as this is commonly misdiagnosed as cellulitis or scleroderma in general practice. Unfortunately, the patient had presented to us at a late stage with wide-spread metastasis, and as such, chemotherapy was the only available option. She expired after her third cycle of chemotherapy.
Erysipelas of the leg (cellulitis) in sub-Saharan Africa: a multicentric study of 562 cases
Our Dermatology Online, 2017
Introduction: Erysipelas of the leg is a common and serious infection. We carried out this study aiming at describing the epidemiological and clinical characteristics, and assessing the risks factors associated with the local complications of erysipelas of the leg in sub-Saharan Africa. Methods: This was a prospective multicentric study carried out in the dermatology units of Hospitals located in seven sub-Saharan African countries during a period of 12 months. Patients aged 15 and above with a first episode of erysipelas of the leg were recruited. Results: In this study, 562 patients were recruited, having a mean age of 43.7±16.9 years and a sex-ratio (M/F) of 0.67. Patients infected on one leg were 562 while those infected with two were 27. Bullous forms of the disease were observed in 95 patients, while purpuric forms were observed in 167 patients. The existence of a point of entry (485 cases), obesity (230), lymph edema (130) and the use of bleaching agents (97) were the mains risk factors. Complications during the course of the infection such as necrotizing fasciitis (34 cases) and abscesses (63 cases) were observed. They were due to the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm. Conclusion: This study reveals that existence of a point of entry, obesity and lymph edema, and the use of bleaching agents were the mains risk factors influencing the local complications of erysipelas of the leg. Necrotizing fasciitis and abscesses were influenced by the use of antibiotics and non-steroidal anti-inflammatory treatments, and the use of cataplasm.