KAVITA NATHAN

Group 318
 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.
 Bacteria
inoculation into
an area of skin,
trauma is the
initial event in
the developing
erysipelas
 In 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.
Regional
lymphnode
swelling
and
tenderness
 A cut in the skin

Problem with drainage through

the veins or lymph system

Skin sores( ulcers)

 Streptococcal toxins are
thought to contribute to the
brisk inflammation that is
pathognomonic of this
infection.

they clearly coexist with

streptococci at sites of
inoculation.
Recently, atypical forms
reported to be caused by :
* Streptococcus
pneumoniae,
*Klebsiella pneumoniae,
* Haemophilus
influenzae,
*Yersinia enterocolitica,
*Moraxella species,
 * Streptococci are the
primary cause of erysipelas.
* Most facial infections are
attributed to group A
streptococci,
*lower extremity
infections being caused by
nongroup A streptococci.
 Group A beta- hemolytic streptocci
Hemolytic streptococcus
Skin infection
Painful rashes
Erythematous rash
Edematous rash
Skin ulcer
Abrasions
Skin ulcer
Insect bite
eczema
 Blisters
Fever, shaking, and chills
Painful, very red, swollen, and
warm skin underneath the sore
(lesion)
Skin lesion with a raised border
Sores (erysipelas lesions) on the
cheeks and bridge of the nose
 Erysipelas begins as a small
erythematous patch that
progresses to a fiery-red,
indurated , tense, and shiny
plaque
 The lesion classically exhibits raised
sharply demarcated advancing
margins.
Local signs of inflammation
warmth,
edema,
tenderness
are universal.
Lymphatic
involvement
often is
manifested by
overlying skin
streaking and
regional
lymphadenopa
thy
More severe
infections may
exhibit
numerous
vesicles and
bullae along
with petechiae
and even
frank necrosis.
 Erysipelasis diagnosed
based on how the skin
looks. A biopsy of the
skin is usually not
needed.
 1) Erythema Annulare
Centri-fugum
2) Stasis Dermatitis
3) Cellulitis
4) Erysipeloid
*
Eruptions
occur at
any age.
Lesions most
often appear on
the thighs,
legs, face,
trunk and arms.
linked to
underlying
diseases ,
viral , bacterial
or even tumor.
 * 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.
 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.
 * 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.
*A first-generation
cephalosporin or
macrolide, such as
erythromycin or
azithromycin, may be
used if the patient has
an allergy to penicillin.
 Two new drugs:
roxithromycin &
pristinamycin,
have been
reported to be
extremely effective
in the treatment of
erysipelas.
 With treatment, the
outcome is good. It may
take a few weeks for the
skin to return to normal.
Peeling is common.
 In 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 infection
Septic shock
 abscess,
gangrene,
Thrombophlebitis .
acute glomerulonephritis ,
endocarditis ,
septicemia,
streptococcal toxic shock
syndrome.
Patients with recurrent
erysipelas should be
educated regarding :
local antisepstic .
general wound care.
Predisposing lower
extremity skin lesions
(eg ,tineapedis , toe
webintertrigo ,stasis
ulcers) should be treated
 Keepyour skin healthy
by avoiding dry skin
and preventing cuts
and scrapes. This may
reduce the risk for
erysipelas.
 Patients with acute
infections involving the
extremities should be
encouraged to limit their
activity and keep the limb
elevated to decrease
swelling.
THANK