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Erysipelas, Emergency Medicine

Irving Jacoby Reviewed 06/2017
 


Basics

Description

  • Superficial bacterial infection of the skin with prominent lymphatic involvement

  • Leukocytosis is common

  • Positive blood cultures in 3–5%

Etiology

  • Group A β-hemolytic streptococcus is the ...

Diagnosis

Signs and Symptoms

  • Most common sites of involvement are the face (5–20% of cases), lower legs (70–80% of cases), and ears

  • Skin has an intense fiery red color, hence the name “Saint Anthony's f...

Treatment

Pre-Hospital

Wearing gloves, followed by hand washing when managing patients, to decrease risk of transmission of streptococcal carriage 

Initial Stabilization/Therapy

Patients may be toxic and...

Follow-Up

Disposition

Admission Criteria

  • Patients with extensive involvement, fever, toxic appearance, or in whom orbital or periorbital cellulitis is suspected

  • Patients who live alone or are unable or u...

Pearls and Pitfalls

  • Failure to respond, or pain out of proportion to findings, might suggest deeper level of infection and require further workup to rule out necrotizing fasciitis, or mixed aerobic/an...

Additional Reading

  • Damstra  RJ, van Steensel  MA, Boomsma  JH, et al. Erysipelas as a sign of subclinical primary lymphoedema: A prospective quantitative scintigraphic study of 40 patients with unilat...

Codes

ICD9

035 Erysipelas 

ICD10

A46 Erysipelas 

SNOMED

  • 44653001 Erysipelas (disorder)

  • 240425002 Facial erysipelas (disorder)

  • 402924002 Recurrent erysipelas (disorder)

  • 44464006 Postpartum AND/OR puerperal ery...

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