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General Medicine

Erysipelas

Fozia Akhtar Ali, MD and Barbara M. Kiersz, DO Reviewed 06/2018
 


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, then activity as tolerated 

Patient Monitoring

Patients should be treated until all symptoms and skin m...

REFERENCES

1
Gabillot-Carré M, Roujeau JC. Acute bacterial skin infections and cellulitis. Curr Opin Infect Dis.  2007;20(2):118–123. [View Abstract on OvidMedline]
2
Celestin R, Brown J, Kihiczak ...

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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