Erysipelas: Causes, Symptoms, Diagnosis, Treatment, and Prevention
The skin infection Erysipelas is caused by a type of bacteria referred to as group A Streptococcus. It can enter the skin through cuts, sores, or other injuries. It can affect any part of the body, but it is most prevalent on the face and legs. A severe case can cause blisters or purple rashes that are red, swollen, and painful. It can also cause fever, chills, headaches, and fatigue. Leaving erysipelas untreated can lead to serious complications such as blood infection, tissue damage, or gangrene.
Causes of Erysipelas
Streptococcus group A bacteria cause erysipelas, which is typically found on the skin or in the throat of healthy people. Infection can, however, be caused by these bacteria if they penetrate the skin through a break in the skin barrier, such as a cut, wound, ulcer, or insect bite. The following factors can increase your risk of getting erysipelas:
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Having a pre-existing skin condition, such as eczema, impetigo, or fungal infection
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Having a weakened immune system due to certain diseases, such as diabetes, cancer, or HIV
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Taking medications that suppress the immune system, such as chemotherapy or organ transplant drugs
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Having poor circulation or lymphatic drainage, such as in obesity, venous disease, or alcoholism
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Having a history of previous episodes of erysipelas or cellulitis
Erysipelas is not contagious, which means it cannot be spread from person to person. However, it can recur in the same person if the underlying cause is not treated or prevented.
Symptoms of Erysipelas
The first sign of erysipelas is usually an unwell feeling followed by a red, swollen, and shiny rash. There may be a raised border on the rash and it may be clearly distinguished from normal skin. It may also feel hot, tender, and painful to touch. It may form blisters or ulcers that leak pus or fluid. In some cases, the rash can also spread to other parts of the body, such as the arms, torso, or ears. Other symptoms of erysipelas may include:
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Fever and chills
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Shivering and sweating
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Headache and nausea
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Loss of appetite and weight loss
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Swollen lymph nodes near the affected area
The symptoms of erysipelas can develop quickly, within a few hours or days of the bacterial infection. They can also vary in severity, depending on the extent of the infection and the response of the immune system.
Diagnosis of Erysipelas
A doctor can diagnose erysipelas based on its appearance and symptoms, as well as a patient's medical history and risk factors. Several signs of infection can be detected by a blood test, such as high levels of white blood cells or C-reactive protein. A skin swab or biopsy may be taken to identify the type of bacteria that is causing the infection, but this is not always possible or necessary. A similar but deeper skin infection is cellulitis, which is sometimes confused with erysipelas. A major difference between erysipelas and cellulitis is that erysipelas affects only the upper layers of the skin while cellulitis affects deeper layers and fat tissue. A more distinct and raised border is also characteristic of erysipelas compared to cellulitis.
Treatment of Erysipelas
The infection can be treated with antibiotics, which can kill the bacteria and stop it from spreading. Antibiotics can be given either orally or intravenously, based on the severity of the infection and the patient's response. For cases of erysipelas caused by MRSA (methicillin-resistant Staphylococcus aureus), penicillin or erythromycin are the most commonly used antibiotics, while vancomycin is used for cases caused by MRSA (methicillin-resistant Staphylococcus aureus). For complicated cases, antibiotic treatment may last for up to 14 days. To prevent the infection from returning or becoming resistant to the antibiotics, it is important to complete the full course of antibiotics prescribed by the doctor, even if the symptoms improve.
In addition to antibiotics, other treatments for erysipelas may include:
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Painkillers, such as paracetamol or ibuprofen, to reduce pain and fever
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Antihistamines, such as cetirizine or loratadine, to reduce itching and inflammation
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Moisturizers, such as emollients or creams, to soothe and hydrate the skin
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Dressings, such as gauze or bandages, to protect and cover the skin lesions
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Elevation, such as raising the affected limb above the heart level, to reduce swelling and improve blood flow
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Compression, such as wearing stockings or wraps, to support the veins and lymphatic vessels
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Surgery, such as debridement or amputation, to remove dead or infected tissue in severe cases
Prevention of Erysipelas
Erysipelas can be prevented by taking care of the skin and avoiding injuries that can allow bacteria to enter the skin. Some preventive measures include:
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Washing the skin regularly with mild soap and water, and drying it gently
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Moisturizing the skin daily with emollients or creams, especially if it is dry or cracked
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Treating any skin conditions, such as eczema, impetigo, or fungal infection, as soon as possible
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Protecting the skin from cuts, scrapes, burns, or bites, by wearing gloves, shoes, or clothing
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Cleaning and covering any wounds or sores with sterile dressings, and changing them regularly
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Seeking medical attention for any signs of infection, such as redness, swelling, pain, or pus
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Taking antibiotics as prescribed by the doctor, and completing the full course of treatment
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Avoiding or limiting alcohol consumption, smoking, and drug use, which can impair the immune system and the circulation
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Maintaining a healthy weight, diet, and exercise, which can improve the immune system and the circulation
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Getting vaccinated against streptococcal infections, such as the pneumococcal vaccine, which can protect against some strains of group A Streptococcus
By recognizing the symptoms, seeking medical attention, and following the treatment and prevention guidelines, erysipelas can be cured and prevented from recurring.
