Erysipelas
Basics
Basics
Basics
Description
Description
- Superficial bacterial infection of the skin with prominent lymphatic involvement
- Leukocytosis is common
- Positive blood cultures in 3–5%
- Involves the upper dermis including the superficial lymphatics
- In contrast, cellulitis affects the deeper dermis and subcutaneous fat
Etiology
Etiology
- Group A β-hemolytic streptococcus is the causative organism (less commonly, group C or G streptococci)
- Portals of entry:
- Skin ulcers
- Local trauma
- Abrasions
- Psoriatic or eczematous lesions
- Fungal infections
Pediatric Considerations
- Haemophilus influenzae type b (HIB) causes facial cellulitis in children that may appear similar to erysipelas:
- Should be considered in unimmunized children
- Many will be bacteremic and require admission
- Cefuroxime or other appropriate H. influenzae coverage is important
- H. influenzae is much less common since widespread use of the HIB vaccine
- Group B streptococci can cause erysipelas in the newborn
- Can develop from infection of umbilical stump
Pregnancy Considerations
- Erythema of the breast in puerperal mastitis is often caused by Staphylococcus organisms, hence methicillin-resistant S. aureus (MRSA) should be covered
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