Erysipelas
To view the entire topic, please log in or purchase a subscription.
Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
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
- 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
- See Mastitis
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
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
- 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
- See Mastitis
There's more to see -- the rest of this topic is available only to subscribers.