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General Medicine

Erysipelas

Fozia Akhtar Ali, MD, Barbara M. Kiersz Muller, DO and Sanna R. Bhajjan, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Distinct form of cellulitis: notable for acute, well-demarcated, superficial bacterial skin infection with lymphatic involvement almost always caused by Streptococcus pyogenes

  • Usually...

DIAGNOSIS

Prodromal symptoms before the skin eruption of erysipelas may include: 

  • Moderate- to high-grade fever

  • Chills

  • Headache

  • Malaise

  • Anorexia, usually in the first 48 hours

  • Vomiting

  • Arthralgias

ALERT

It is ...

TREATMENT

GENERAL MEASURES

  • Symptomatic treatment of myalgias and fever

  • Adequate fluid intake

  • Local treatment with cold compresses

  • Elevation of affected extremity

  • Appropriate therapy for any underlying pred...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Bed rest with elevation of extremity during acute infection and then activity as tolerated 

Patient Monitoring

Patients should be treated until all symptoms and ski...

REFERENCES

1
Gabillot-Carré M, Roujeau JC. Acute bacterial skin infections and cellulitis. Curr Opin Infect Dis.  2007;20(2):118–123.
2
Celestin R, Brown J, Kihiczak G, et al. Erysipelas: a common p...

ADDITIONAL READING

Gilbert D, Chambers HF, Eliopoulos GM, et al, eds. The Sanford Guide to Antimicrobial Therapy. 44th ed. Sperryville, VA: Antimicrobial Therapy; 2014. 

CODES

ICD10

A46 Erysipelas 

ICD9

035 Erysipelas 

SNOMED

  • 44653001 Erysipelas (disorder)

  • 402925001 Erysipelas of lower limb (disorder)

  • 240425002 Facial erysipelas (disorder)

CLINICAL PEARLS

  • Athlete’s foot is the most common portal of entry.

  • Erysipelas is distinguished from cellulitis by its sharp, shiny, fiery-red, raised border.

  • In recurrent cases, search for other possibl...

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Related Images
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Figure 14.28. A. Cellulitis. B. Erysipelas in a patient with Down syndrome.
Figure 14.28. A. Cellulitis. B. Erysipelas in a patient with Down syndrome.
Figure 14.28. A. Cellulitis. B. Erysipelas in a patient with Down syndrome.
Figure 14.28. A. Cellulitis. B. Erysipelas in a patient with Down syndrome.
Figure 24-22 Erysipelas. This patient has large, confluent erythematous plaques. A bulla is present near the angle of her jaw.
Figure 24-22 Erysipelas. This patient has large, confluent erythematous plaques. A bulla is present near the angle of her jaw.
Erysipelas. This patient has large, confluent erythematous plaques. A bulla is present near the angle of her jaw.Thomas H. McConnell, The Nature Of Disease Pathology for the Health Professions, Philadelphia: Lippincott Williams & Wilkins, 2007
Erysipelas. This patient has large, confluent erythematous plaques. A bulla is present near the angle of her jaw.Thomas H. McConnell, The N...
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