Erysipelas (otherwise erysipelas) refers to contagious infectious diseases, the course of which is accompanied by a high risk of developing severe complications, up to death.

Erysipelas disease is transmitted by contact (through touch, personal items, etc.), however, the level of contagiousness of the disease (contagiousness) is quite low, therefore, despite the fact that erysipelas is quite common throughout the world, mass outbreaks of the disease, as a rule, are not registered.

An infectious disease of erysipelas is caused by B-hemolytic streptococcus. The high incidence of the disease (about 200 people per 10 thousand people in Russia) is due to the prevalence of the infectious agent.

Attention. The source of bacteria can be not only patients with erysipelas, but also patients with acute and chronic forms of streptococcal tonsillitis.

Erysipelas is an infectious pathology of streptococcal etiology, occurring in the most acute (primary initiation by streptococci) or chronic (with the occurrence of relapses) form.

For reference. Erysipelas disease in humans is accompanied by the development of symptoms of severe intoxication, fever, lymphadenitis, lymphangitis, as well as damage to the dermis with the formation of serous or hemorrhagic-serous inflammatory foci.

The code for erysipelas according to ICD10 is A46.

Erysipelas - the etiology of infection

The causative agent of erysipelas is characterized by a high level of resistance to environmental factors. However, they are rapidly destroyed by heating (at temperatures above 56 degrees, streptococci are destroyed within thirty minutes) and treated with antimicrobial and disinfectants.

It should be noted that according to recent studies, in the development of erysipelas of a hemorrhagic-bullous nature, in addition to group A streptococci (B-hemolytic type), Staphylococcus aureus and some gram-negative bacteria (Escherichia coli, Proteus) may also participate.

For reference. Erysipelas caused by mixed bacterial microflora is more severe and less treatable.

Epidemiological features of erysipelas

Erysipelas are among the most common dermatological pathologies. The maximum rise in the disease occurs in summer and autumn.

In patients under twenty years of age, erysipelas practically does not occur. Erysipelatous inflammation of newborns, characterized by an extremely high level of mortality, is practically not found at the moment.

Between the ages of twenty and thirty, erysipelas is more common in men than in women. This is due to a higher level of injuries and the impact of professional factors (drivers, masons, mechanics, locksmiths, loaders, etc.)

For reference. Most often, erysipelas is recorded in patients older than fifty years (men and women at this age get sick equally often).

Also, the infection is often recorded in housewives and elderly patients. In this category of patients, the disease usually occurs in a frequently relapsing form.

For reference. In patients with various immunodeficiencies, the course of erysipelas is accompanied by high risks of developing complications of a destructive and purulent-necrotic nature (necrotic forms of cellulite, fasciitis, etc.).

How is erysipelas transmitted?

The disease is contagious. However, due to the fact that pathogens are widespread everywhere, erysipelas is a low contagious infection. Even family outbreaks of erysipelas are extremely rare.

Attention. The likelihood of getting erysipelas increases if the patient has risk factors (decreased immunity, open wounds, etc.). Approximately ten percent of patients have a hereditary predisposition to this infection.

Infection with the causative agent of infection can occur:

contact and household contact routes (erysipelas can be transmitted by touching, using towels, sheets, clothes, dishes, etc. contaminated with streptococci);
by airborne droplets, when coughing, sneezing and talking (typical for patients with foci of chronic streptococcal infections in the nasopharynx).

It is also possible lymphogenous or hematogenous infection from distant infectious foci (streptococcal pyoderma, retropharyngeal abscesses of the pharynx, etc.).

Erysipelas - causes

A risk factor contributing to the appearance of erysipelas is the presence of abrasions, scratches, cracks, scratches, etc. in the patient.

Erysipelatous inflammation of the face often occurs due to the ingress of streptococci on damaged skin of the nostrils or external auditory canal, less often inflammation develops due to cracks in the corners of the mouth.

Erysipelatous inflammation of the leg may be associated with the appearance of cracks on the heels, abrasions and scratches, cracks in the skin covering the interdigital spaces.

is an infectious disease caused by group A streptococcus, mainly affecting the skin and mucous membranes, characterized by the occurrence of limited serous or serous-hemorrhagic inflammation, accompanied by fever and general intoxication. Clinically, erysipelas is characterized by a typical bright red edematous skin lesion with clear boundaries and signs of lymphostasis. Complications of erysipelas include: the formation of necrotic foci, abscesses and phlegmon, thrombophlebitis, secondary pneumonia, lymphedema, hyperkeratosis, etc.

ICD-10

A46

General information

(erysipelas) is an infectious disease caused by group A streptococcus, mainly affecting the skin and mucous membranes, characterized by the occurrence of limited serous or serous-hemorrhagic inflammation, accompanied by fever and general intoxication. Erysipelas is one of the most common bacterial infections.

Exciter characteristic

Erysipelas is caused by group A beta-hemolytic streptococcus, most often of the species Streptococcus pyogenes, which has a diverse set of antigens, enzymes, endo- and exotoxins. This microorganism can be an integral part of the normal flora of the oropharynx, present on the skin of healthy people. The reservoir and source of erysipelas infection is a person, both suffering from one of the forms of streptococcal infection, and a healthy carrier.

Erysipelas is transmitted by aerosol mechanism mainly by airborne droplets, sometimes by contact. The entrance gates for this infection are damage and microtrauma of the skin and mucous membranes of the oral cavity, nose, and genital organs. Since streptococci often live on the surface of the skin and mucous membranes of healthy people, the risk of infection if basic hygiene is not followed is extremely high. Individual predisposition factors contribute to the development of infection.

Women get sick more often than men, susceptibility increases with prolonged use of drugs from the group of steroid hormones. The risk of developing erysipelas is 5-6 times higher in people suffering from chronic tonsillitis and other streptococcal infections. Facial erysipelas more often develops in people with chronic diseases of the oral cavity, ENT organs, caries. Damage to the chest and limbs often occurs in patients with lymphovenous insufficiency, lymphedema, edema of various origins, with fungal lesions of the feet, and trophic disorders. Infection can develop in the area of post-traumatic and post-operative scars. There is some seasonality: the peak incidence occurs in the second half of summer - the beginning of autumn.

The causative agent can enter the body through damaged integumentary tissues, or, with an existing chronic infection, penetrate into the capillaries of the skin with a blood stream. Streptococcus multiplies in the lymphatic capillaries of the dermis and forms a focus of infection, provoking active inflammation or latent carriage. Active reproduction of bacteria contributes to the massive release of their metabolic products (exotoxins, enzymes, antigens) into the bloodstream. The consequence of this is intoxication, fever, probably the development of toxic-infectious shock.

Erysipelas classification

Erysipelas is classified according to several criteria: according to the nature of local manifestations (erythematous, erythematous-bullous, erythematous-hemorrhagic and bullous-hemorrhagic forms), according to the severity of the course (mild, moderate and severe forms, depending on the severity of intoxication), according to the prevalence of the process (localized, common, migratory (wandering, creeping) and metastatic). In addition, primary, repeated and recurrent erysipelas are distinguished.

Recurrent erysipelas is a recurring event between two days and two years after the previous episode, or recurrence occurs later, but the inflammation repeatedly develops in the same area. Repeated erysipelas occur no earlier than two years later, or are localized in a place different from the previous episode.

Localized erysipelas is characterized by the restriction of infection to a local focus of inflammation in one anatomical region. When the focus goes beyond the boundaries of the anatomical region, the disease is considered common. The addition of phlegmon or necrotic changes in the affected tissues are considered complications of the underlying disease.

Symptoms of erysipelas

The incubation period is determined only in the case of post-traumatic erysipelas and ranges from several hours to five days. In the vast majority of cases (more than 90%), erysipelas has an acute onset (the time of onset of clinical symptoms is noted to the nearest hour), fever develops rapidly, accompanied by symptoms of intoxication (chills, headache, weakness, body aches).

Severe course is characterized by the occurrence of vomiting of central origin, convulsions, delirium. After a few hours (sometimes the next day), local symptoms appear: on a limited area of \u200b\u200bthe skin or mucous membrane, there is a burning sensation, itching, a feeling of fullness and moderate pain when touched, pressed. Severe pain is characteristic of erysipelas of the scalp. There may be pain in regional lymph nodes during palpation and movement. Erythema and swelling appear in the focus area.

The peak period is characterized by the progression of intoxication, apathy, insomnia, nausea and vomiting, symptoms from the central nervous system (loss of consciousness, delirium). The focus area is a dense bright red spot with clearly defined uneven borders (symptom of "tongues of flame" or "geographic map"), with severe edema. The color of erythema can vary from cyanotic (with lymphostasis) to brownish (with trophic disorders). There is a short-term (1-2 s) disappearance of redness after pressure. In most cases, compaction, limited mobility and pain on palpation of regional lymph nodes are found.

Fever and intoxication persist for about a week, after which the temperature returns to normal, regression of skin symptoms occurs somewhat later. Erythema leaves behind fine scaly peeling, sometimes pigmentation. Regional lymphadenitis and skin infiltration in some cases may persist for a long time, which is a sign of a likely early relapse. Persistent edema is a symptom of developing lymphostasis. Erysipelas is most often localized on the lower extremities, then, according to the frequency of development, there is an erysipelas of the face, upper extremities, chest (erysipelas of the chest is most characteristic of the development of lymphostasis in the area of the postoperative scar).

Erythematous-hemorrhagic erysipelas is distinguished by the presence of hemorrhages from the area of the local focus against the background of general erythema: from small (petechiae) to extensive, confluent. The fever in this form of the disease is usually longer (up to two weeks) and the regression of clinical manifestations is noticeably slower. In addition, this form of erysipelas may be complicated by necrosis of local tissues.

In the erythematous-bullous form, vesicles (bulls) form in the area of erythema, both small and rather large, with transparent contents of a serous nature. Bubbles appear 2-3 days after the formation of erythema, open on their own, or they are opened with sterile scissors. Bulla scars with erysipelas usually do not leave. With a bullous-hemorrhagic form, the contents of the vesicles are serous-hemorrhagic in nature, and, often, are left after opening erosion and ulceration. This form is often complicated by phlegmon or necrosis; after recovery, scars and areas of pigmentation may remain.

Regardless of the form of the disease, erysipelas has its own course in different age groups. In old age, primary and repeated inflammation is usually more severe, with an extended period of fever (up to a month) and exacerbation of existing chronic diseases. Inflammation of regional lymph nodes is usually not observed. The subsidence of clinical symptoms occurs slowly, relapses are not uncommon: early (in the first half of the year) and late. The frequency of relapses also varies from rare episodes to frequent (3 or more times per year) exacerbations. Often recurrent erysipelas is considered chronic, while intoxication often becomes quite moderate, erythema has no clear boundaries and is paler, lymph nodes are not changed.

Complications of erysipelas

The most common complications of erysipelas are suppuration: abscesses and phlegmon, as well as necrotic lesions of the local focus, ulcers, pustules, inflammation of the veins (phlebitis and thrombophlebitis). Sometimes secondary pneumonia develops, with a significant weakening of the body, sepsis is possible.

Long-term stagnation of the lymph, especially in the relapsing form, contributes to the occurrence of lymphedema and elephantiasis. Complications of lymphostasis also include hyperkeratosis, papillomas, eczema, lymphorrhea. Persistent pigmentation may remain on the skin after clinical recovery.

Diagnostics

Diagnosis of erysipelas is usually based on clinical symptoms. A consultation with a dermatologist may be required to differentiate erysipelas from other skin conditions. Laboratory tests show signs of a bacterial infection. Specific diagnosis and isolation of the pathogen, as a rule, are not performed.

Treatment of erysipelas

Erysipelas is usually treated on an outpatient basis. In severe cases, with the development of purulent-necrotic complications, frequent relapses, in senile and early childhood, the placement of the patient in a hospital is indicated. Etiotropic therapy consists in prescribing a course of antibiotics of the cephalosporin series of the first and second generations, penicillins, some macrolides, fluoroquinolones lasting 7-10 days in medium therapeutic dosages. Erythromycin, oleandomycin, nitrofurans and sulfonamides are less effective.

With frequent relapses, the sequential appointment of two types of antibiotics of different groups is recommended: after beta-lactams, lincomycin is used. Pathogenetic treatment includes detoxification and vitamin therapy, antihistamines. With bullous forms of erysipelas, the blisters are opened and frequently replaced gauze wipes with antiseptic agents are applied. Ointments are not prescribed so as not to once again irritate the skin and not slow down healing. Topical preparations may be recommended: dexpanthenol, silver sulfadiazine. As a means of accelerating the regression of skin manifestations, physiotherapy is recommended (UHF, UV, paraffin, ozokerite, etc.).

In some cases of recurrent forms, patients are prescribed courses of anti-relapse treatment with benzylpenicillin intramuscularly every three weeks. Persistently recurrent erysipelas is often treated with courses of injections for two years. With the presence of residual effects after discharge, patients may be prescribed a course of antibiotic therapy for up to six months.

Forecast

Erysipelas of a typical course usually has a favorable prognosis and, with adequate therapy, ends in recovery. A less favorable prognosis occurs in the case of complications, elephantiasis and frequent relapses. The prognosis worsens in debilitated patients, senile people, people suffering from beriberi, chronic diseases with intoxication, digestive disorders and lymphovenous apparatus, immunodeficiency.

Prevention

General prevention of erysipelas includes measures for the sanitary and hygienic regime of medical institutions, compliance with the rules of asepsis and antiseptics when treating wounds and abrasions, prevention and treatment of pustular diseases, caries, streptococcal infections. Individual prevention consists in maintaining personal hygiene and timely treatment of skin lesions with disinfectants.

Erysipelas disease is an acute infectious disease caused by the bacteria Streptococcus pyogenes. It is characterized by symptoms of general intoxication and manifestations of the inflammatory process on the skin. If you have this disease once, there is a chance of a relapse.

Localization and prevalence

The disease affects people of all ages and social groups. Most often, erysipelas is observed in men aged 25-40, engaged in physical labor (loaders, builders, workers), since their skin is daily exposed to adverse mechanical effects. In the category of older people, women are more likely to get sick. The disease is equally common in all climatic zones.

Erysipelas disease causes

Erysipelas can occur both with direct contact of streptococcus with the damaged area, and as a result of the transfer of the pathogen along the lymphatic tract from the focus of chronic infection. Not every person who has had contact with streptococcus develops erysipelas. For the appearance of a detailed clinical picture, several predisposing factors are necessary:

The presence of an active infectious focus (chronic tonsillitis, caries).
Reduced tolerance to streptococcal flora (considered a genetic factor).
Decreased overall body resistance.
The presence of severe comorbidity.
Postoperative complications.
Long-term treatment with glucocorticosteroids.

Erysipelas is transmitted both from a sick person and from a bacteriocarrier, who may not have symptoms of the disease at all.

Erysipelas symptoms and forms

Usually the disease begins acutely, so that patients can accurately indicate the day and hour of its occurrence. At the first stage, the leading symptoms of the disease are manifestations of the syndrome of general intoxication:

rapid increase in body temperature to febrile (38-39C);
chills;
pain in muscles and joints;
nausea, sometimes vomiting.

After some time, local redness appears on the skin, accompanied by a feeling of pain and burning. Depending on the shape of the erysipelas, the affected area may appear:

Only redness and swelling erythematous form.
Spotted red rash hemorrhagic form.
Bubbles filled with clear liquid bullous form.

The same patient may have mixed forms - erythematous-bullous, bullous-hemorrhagic or erythematous-hemorrhagic. Regional lymph nodes enlarge and become painful to the touch. With a moderate course, the resolution of the disease occurs in a week. Bullous blisters leave behind crusts that can go off for a long time, turning into trophic ulcers and erosion. With a successful outcome of the pathological process, the site of the lesion is cleared of crusts, begins to peel off and eventually heals without a trace.

Erysipelas disease on the face appears with a primary lesion, and on the trunk and limbs it usually recurs.

Diagnosis of erysipelas

The diagnosis is made on the basis of the patient's complaints, the history of the disease and the results of laboratory tests. In the blood of patients, a typical manifestation of the inflammatory process caused by a bacterial infection is observed: an increase in leukocytes, neutrophilia, an increase in ESR. It is important to correctly differentiate erysipelas from other diseases: phlegmon, anthrax, toxicoderma, scleroderma, systemic lupus erythematosus.

Erysipelas treatment

Therapy consists in the use of antibacterial agents both internally and externally. The drugs of choice for the development of streptococcal infection are:

penicillin;
erythromycin;
clindamycin.

The doctor chooses one of these antibiotics based on the individual characteristics of the patient. The course of treatment is at least a week. Effective is the appointment of antibiotics in combination with nitrofuran derivatives. Locally (for example, when an erysipelas disease appears on a leg or arm), various ointments and powders with an antimicrobial effect are applied to the affected skin. Therapy is supplemented with the use of antipyretic drugs, vitamins, painkillers and antihistamines. During the period of illness, the patient must comply with strict bed rest and diet. Plentiful drinking is shown.

Treatment of erysipelas with folk remedies

It is possible to treat erysipelas with folk remedies:

Crumble ordinary white chalk, sift out large particles through a sieve and sprinkle the affected skin area with the resulting powder.
Lubricate reddened skin with pork fat or propolis.
Apply chopped bark of bird cherry or lilac to the affected areas.
Mix 1 tablespoon of chamomile flowers with 1 tablespoon of coltsfoot leaves and 1 tablespoon of honey. Lubricate the skin in the affected areas with the resulting mixture.
1 tablespoon of yarrow leaves pour a glass of water. Cook over low heat for 10 minutes. Strain, cool, apply to the affected areas.

Erysipelas prognosis and complications

With timely diagnosis and the appointment of adequate therapy, the prognosis is favorable. The disease may recur. The appearance of erysipelas on the arms or legs most often indicates a re-infection.

Prevention of erysipelas

Specific prophylaxis has not been developed. Follow the rules of personal hygiene, immediately treat any wounds, abrasions, cuts and other skin lesions, preventing contamination.

erysipelas photo

Many have probably heard about the disease of erysipelas. This is an infectious disease that is caused by group A staphylococcal virus. The disease affects the mucous membranes ...

Erysipelas disease: photos, symptoms, diagnosis and treatment

By Masterweb

27.05.2018 04:00

Today it is difficult to find such a person who thoroughly monitors his health. As a result, people are overtaken by various ailments, leading to negative consequences. Many have probably heard about the disease of erysipelas. This is an infectious disease that is caused by group A staphylococcal virus. The disease affects the mucous membranes and skin. Serous or serous-hemorrhagic inflammation appears, which is accompanied by general intoxication and fever. A clear symptom is a bright red edematous skin lesion with signs of lymphostasis. If timely measures are not taken to treat this disease, abscesses, necrotic foci, thrombophlebitis, hyperkeratosis and lymphedema may develop.

The nature of the disease

Let's dwell on this in more detail. Today, erysipelas is a common bacterial infection. It is caused by the pathogen Streptococcus pyogenes. This microorganism can also be present on the skin of a healthy person. Erysipelas is transmitted by airborne droplets or by contact. The infection can penetrate through microtraumas on the mucous membranes and skin. The risk of infection increases significantly if hygiene rules are not followed. Also, factors of individual predisposition can contribute to the development of the disease under discussion.

It is believed that women suffer from the disease more often than men. With prolonged use of drugs of the steroid hormone group, susceptibility increases significantly. The risk of developing erysipelas in people with chronic tonsillitis is quite high. Also, erysipelas can develop in patients with diseases of the ENT organs. The defeat of the limbs and chest usually occurs in patients suffering from lymphedema and edema, fungal infections. Often, erysipelas develops in the area of postoperative and post-traumatic scars. The peak incidence occurs at the end of summer - the beginning of autumn.

The pathogen can enter the body through damage to the skin or penetrate into the capillaries of the skin with a blood stream. Streptococcus multiplies in lymphatic cells. It is in them that a focus of infection occurs, which provokes the development of active inflammation. Due to the active reproduction of bacteria, a massive release of their metabolic products into the blood is observed. As a result, the patient may feel signs of intoxication, fever, toxic-infectious shock.

Classification

How is erysipelas treated? Symptoms of the disease may vary depending on its type.

Pathology is classified according to the following features:

By the nature of the manifestation: erythematous-bullous, erythematous, erythematous-hemorrhagic, bullous-hemorrhagic.
According to the severity of treatment: mild, severe, moderate.
According to the prevalence of the process: migratory, localized, widespread, metastatic.

The disease can also be of the primary, recurrent, or relapsing type. The interval of recurrence of symptoms of the disease can be from two days to two years. Usually inflammation develops in the same area. As a rule, repeated erysipelas occur no earlier than two years later. Its localized form is characterized by the restriction of the site of infection to one anatomical region. If it goes beyond its borders, then the disease is common. Necrotic changes in the affected tissues are already considered complications.

Symptoms

This issue should be given special attention. How does erysipelas manifest itself? Symptoms and treatment depend on the type of disease. On average, the incubation period can last from a few hours to five days. Erysipelatous inflammation in most cases begins to develop quite rapidly. Clinical symptoms may appear within 2 hours. A fever appears, and with it signs of intoxication, such as general weakness, chills, headache, body aches.

In severe cases, vomiting, delirium, and convulsions may occur. A few days later, local symptoms appear. A characteristic burning sensation is felt on the mucous membrane or a limited area of \u200b\u200bthe skin. There may be mild pain on palpation. With erysipelas of the scalp, severe pain is characteristic. In the area of the lesion, swelling and erythema form.

During the peak period, the focus area turns out to be painted in a bright red color. The spot has clearly defined uneven borders. The color may vary from cyanotic to brownish. After pressing, a short-term disappearance of redness is noted. Usually, a seal occurs on the affected area. On palpation, the area is quite painful.

Signs of intoxication persist for 7 days. Then the temperature gradually returns to normal. Skin symptoms disappear much later. After erythema, small scaly peeling remains. In some cases, pigment spots may appear at the site of the lesion. A sign of early recurrence may be skin infiltration and regional lymphadenitis. Persistent edema testifies to the development of lymphostasis. Most often, erysipelas on the leg is manifested. The reasons lie in the specifics of the development of infection.

Also, cases of erysipelas on the face are often recorded. Usually we are talking about the area around the nose and lips, corners of the mouth and ear. In some cases, vesicles filled with pus or blood form. When they burst, the contents form crusts, after rejection of which you can see renewed young skin.

Features of the course of the disease

Erythematous-hemorrhagic disease of erysipelas is characterized by the presence of hemorrhages in the area of the lesion. With this form of the disease, the fever usually lasts a little longer. The inflammation itself can be complicated by necrosis of local tissues.

The bullous-hemorrhagic form is accompanied by the appearance of bubbles. It is considered one of the most dangerous. Often this form is complicated by necrosis or phlegmon. Even after complete recovery, age spots and scars may remain on the skin.

Dependence on the patient's age

How does erysipelas usually manifest itself? You can see photos of the affected areas of the skin in the article. The manifestation of symptoms can vary greatly depending on the age of the patient. As a rule, the older the person, the more severe the primary and secondary inflammations are. The period of fever can last for a month. Against the background of erysipelas, chronic diseases can worsen. Symptoms are extremely slow, and the likelihood of recurrence is very high. Their frequency varies from rare episodes to frequent exacerbations.

Recurrent erysipelas is considered a chronic disease. Intoxication at the same time becomes very moderate. By itself, erythema may not have clear edges and be quite pale.

Complications

What do you need to know about them? What complications can cause erysipelas? Photo, symptoms, and treatment of which are discussed in this review, pathology often leads to the formation of abscesses and necrotic lesions. Unpleasant consequences can also be the formation of phlebitis and thrombophlebitis, or, more simply, inflammation of the veins. In some cases, secondary pneumonia and sepsis can develop.

As a result of the appearance of prolonged stagnation of the lymph, lymphelema can form. Possible complications also include eczema, papillomas, lymphorrhea, hyperkeratosis.

Diagnostic methods

What are they? How can you tell if you really have erysipelas? Symptoms in adults in the early stages of the development of the disease can be quite contradictory. To distinguish erysipelas from other diseases, you will need to consult a dermatologist. Blood tests usually show evidence of a bacterial infection. As a rule, doctors do not resort to specific diagnostics aimed at isolating the causative agent of the infection.

Erysipelas: methods of therapy

Treatment of the disease in question is usually carried out on an outpatient basis. Only in severe cases, when the disease is accompanied by a number of purulent-necrotic complications, the doctor may prescribe inpatient treatment. With etiotropic erysipelas, a course of antibiotics of the cephalosporin series of the first and second generation is prescribed. The treatment period is from 7 to 10 days. Sulfonamides and erythromycin are less effective.

If the patient regularly relapses, then antibiotics of different groups can be sequentially prescribed to him. Usually, after taking beta-lactams, Lincomycin is prescribed.

If the erysipelas on the face proceeds in a bullous form, then the treatment includes procedures for opening the blisters and treating them with antiseptic compounds. To avoid unnecessary skin irritation, the use of ointments is not recommended. Usually, topical preparations such as Silver Sulfadiazine and Dexpanthenol are prescribed. For the speedy regeneration of the skin, the doctor may also prescribe physiotherapy. With frequent relapses, the patient is prescribed intramuscular injections of "Benzylpenicillin".

If, despite all the measures taken, the disease still manifests itself regularly, injections are prescribed in courses for 2 years. If residual effects are found after discharge of patients, antibiotics may be recommended for another six months.

Prevention

Is it possible to protect yourself from such a nuisance as erysipelas? The disease, the causes of which are most often reduced to non-compliance with sanitary and hygienic requirements, will not manifest itself if the infection is properly counteracted. Individual prevention consists mainly in the proper treatment of lesions on the skin. With the formation of abrasions or wounds, they must immediately be wiped with disinfectant compounds. Take special care when handling them.

Forecast

This question interests all patients. With proper therapy, erysipelas is highly treatable. However, with the appearance of complications and frequent relapses, the likelihood of a quick recovery is markedly reduced. Negative factors that reduce the rate of skin regeneration are also weak immunity and body resistance, advanced age, beriberi, chronic diseases associated with intoxication, disorders of the lymphovenous and digestive systems.

To never experience what erysipelas is, you need to lead a healthy lifestyle. Try to timely engage in the correct treatment of all pathologies, do not allow any of the diseases to become chronic. Since erysipelas often occurs on the lower extremities, try to avoid wearing someone else's shoes. Choose comfortable boots and shoes to avoid blisters and corns.

Try to improve the body's natural defenses. To do this, you need to regularly consume vitamins and carefully select a diet. Also watch your own weight: excess body weight is one of the factors that contributes to the occurrence of complications in erysipelas.

Be sure to strengthen your immune system: do physical exercises and temper yourself. But do not go to extremes - sudden changes in temperature can cause inflammation in the body. At the first signs of infection of the body with a streptococcal infection, use special antibiotics that prevent its reproduction.

Conclusion

In this article, we examined the disease of erysipelas. Symptoms and treatment, photos and methods of prevention - all these issues were disclosed in detail. The causative agent of the disease is a bacterial infection. It can enter the body both by airborne droplets and through contact. The incubation period is 5 to 15 days. The first symptoms of erysipelas are fever and general weakness. Somewhere after a week, dark brown spots may appear on the body. The focus of inflammation is also characterized by increased soreness and induration. Treatment should begin as soon as possible. It is mostly done on an outpatient basis, but in severe cases, hospitalization may be required.

By what signs can you determine that you have an erysipelas disease? Treatment, photo, description of the main symptoms were discussed in detail in this review. However, only a qualified doctor can make a final diagnosis. There are also a number of factors that negatively affect the development of the disease. These include weakened immunity, chronic diseases and advanced age.

There are a number of preventive measures that will help reduce the likelihood of illness. Hygiene requirements must be strictly followed. If injuries and microcracks appear on the skin, be sure to treat them with an antiseptic. This is how you prevent infection.

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At the first stages, the development of symptoms of general intoxication is characteristic, which manifests itself:

severe headache;
chills;
general weakness;
nausea, vomiting;
an increase in body temperature up to 39-40 ° C;
constipation or loose stools.
muscle soreness.

Other symptoms of the disease are:

the appearance of a bright red spot on the surface of the skin. The affected area is hot to the touch, painful, swollen. The spot quickly increases in size, acquiring the shape of flames on the periphery. Sometimes several spots appear on the affected area, interconnected by red stripes. The affected area from the healthy one is limited by a roller-like raised edge, while the center seems to be slightly sunken. Edema and redness are weakly expressed in areas poor in loose subcutaneous tissue, for example, in the area of the nasolabial fold, on the border with the scalp, in the forehead, cheekbones, eyebrows, ankles and, conversely, in areas rich in loose subcutaneous tissue, for example, on the eyelids, scrotum (in men), labia (in women). The edematous skin becomes tense, shiny, acquires a bluish tint, sometimes hemorrhages are observed in the affected area. On palpation (palpation) on the periphery, the affected area is more painful than in the center. The lower extremities, face, and head are most often affected. Erysipelatous lesions occur mainly in areas with circulatory disorders, for example, on the legs against the background of thrombosis.
The reproduction of the pathogen in the lymphatic vessels is accompanied by an increase and soreness of the lymph nodes.
Damage to the nervous system is noted from the first days in the form of headache, sleep disturbances, in severe cases, convulsions and delirium are possible.

Incubation period

From several hours to 3-5 days.

Forms

Erythematous form:
- burning sensation, fullness in the affected area;
- redness and swelling at the site of inflammation;
- foci with clear boundaries, scalloped (in the form of notches, tongues of flame) edges, prone to peripheral growth;
- the skin in the area of the focus is hot to the touch, tense;
- this form is usually characterized by a mild course (from 5 to 8, sometimes 12-14 days), then the inflammation disappears, light pigmentation or peeling remains on the affected areas.
In case of petechial hemorrhages against the background of redness, erythrimatous-hemorrhagic form diseases.
bullous form characterized by the fact that with significant edema, the epidermis (the upper layer of the skin) peels off, which rises, and small or large vesicles (bulls) are formed, filled with liquid contents. Large bubbles, as a rule, are located on the face, genitals, lower extremities. When the blisters burst, their contents turn into yellow crusts. The opening of the blisters and their further healing is accompanied by itching. In a complicated course, erosions (a superficial defect of the skin without scarring) and trophic ulcers (long-term non-healing festering wounds) can form at the site of the blisters. This form is characterized by a longer course and a period of rise in body temperature. After the foci dry out, dense crusts remain.
With small hemorrhages, the contents of the vesicles may have blood impurities, while secreting bullous-hemorrhagic form.
Phlegmous form characterized by the formation of vesicles containing pus, damage to the subcutaneous fatty tissue. This form develops with additional infection of the affected tissue with staphylococcus aureus. There is a sharp pain in the center of the focus.
Gangrenous form characterized by tissue death in the affected areas. More often localized in areas rich in loose subcutaneous tissue (for example, in the eyelids, scrotum (in men)). The form occurs in severe cases in debilitated persons suffering from serious pathologies, persons with chronic alcoholism. After rejection of necrotic (dead) areas, scars remain. Marked pain is noted.

According to the spread of the lesion, there are:

localized erysipelas- a certain area is affected, limited by the anatomical limits of one organ;
wandering face- the process covers a wide area, the pathogen spreads through the lymphatic tract;
metastatic erysipelas- is extremely rare, represents separate isolated foci in areas remote from each other; characterized by hematogenous (that is, through the bloodstream) spread of infection.

Causes

Sources of infection are people suffering from various streptococcal infections, as well as its carriers. The carrier of streptococcal infection itself does not get sick, since its immune system is able to suppress the development of the pathological process. However, the carrier can be a source of infection for people with weak immune systems.

The disease can develop against the background of:

injuries and microtraumas (violations of the integrity of the skin, mucous membranes);
under poor material and domestic and sanitary conditions;
stress;
poor nutrition;
hypothermia or overheating.

Very often, erysipelas occurs against the background of predisposing diseases - foot fungus, diabetes mellitus, varicose veins, lymphostasis (damage to the lymphatic vessels, etc.).

Persons over 50 years of age are most susceptible to the disease (this is explained by the fact that the bactericidal properties of the skin in the elderly are less pronounced than in young people, and the vulnerability of the skin is significantly increased).

Women get sick more often than men.

People who work outdoors, in conditions of hypothermia and a sharp change in temperature, get sick more often.

Infection can occur when using contaminated instruments, dressings.

In this case, the immune status of a person and susceptibility to streptococcal infection are of decisive importance.

Diagnostics

Analysis of the anamnesis and complaints of the disease (when headaches appeared, fever, redness on the skin, whether there was a previous damage to the skin at the site of the lesion (for example, abrasion, scratch), etc.).
Analysis of the history of life (past childhood infections, chronic diseases, injuries, operations, etc.).
General examination (localization of redness, nature of the lesion, severity of edema, etc.).
Inspection of the affected area (when palpated, the peripheral area in the affected area is more painful than in the center).
Analysis of the coagulogram (determination of the main indicators of the blood coagulation system): in the acute period of the disease, increased blood clotting and a tendency to form blood clots or a reverse reaction - bleeding can be detected.
A urinalysis is done to look for albuminuria (the presence of protein in the urine) and erythrocytes (red blood cells in a urine sample). These changes are characteristic of the acute period of the disease development.
Examination of ulcers and the contents of the vesicles in order to isolate the pathogen, while sowing the collected material on nutrient media and determining the sensitivity of this flora to antibiotics.
Express diagnostics of blood based on the methods of latex agglutination and ELISA (enzymatic immunoassay). These are blood tests to determine the antigen of the pathogen and antibodies to it.
Consultation is also possible.

Erysipelas treatment

As part of drug treatment, antibiotics are prescribed (in the form of tablets for oral administration and in the form of ointments for treating affected skin areas). With repeated episodes of erysipelas, antibiotic therapy goes well with cryotherapy (short-term freezing of the surface layers of the skin with a stream of chloroethyl until they turn white).
Restorative therapy (reception of vitamin and mineral complexes).
In some cases, blood/plasma transfusion is indicated.
Physiotherapeutic procedures include UFO (exposure to the skin with ultraviolet rays), also UHF (a treatment method based on the principles of exposing the patient's body to a high-frequency magnetic field), quartz, laser.
In bullous forms, lotions are prescribed with a solution of furacilin.
Hospitalization in the infectious diseases department (severe course, frequent relapses, the presence of severe concomitant diseases, advanced age).

Complications and consequences

Against the background of timely antibiotic treatment, severe complications and consequences are rare.

However, in the elderly, in immunocompromised individuals, the following are possible:

circulatory disorders against the background of cardiovascular diseases;
in the elderly, transient toxic bronchitis (inflammation of the bronchi) occurs;
very rarely (with the addition of a staphylococcal infection and the development of sepsis), inflammatory processes develop in the kidneys (pyelonephritis or glomerulonephritis);
erysipelas against the background of inflammatory kidney disease can lead to the development of renal failure;
thrombophlebitis (inflammation of the vein wall, accompanied by the formation of blood clots);
lymphostasis and the development of elephantiasis (impaired blood circulation and lymphatic drainage, the formation of lymphatic edema and an increase in the size of the affected part of the body). Sometimes a lymphatic fistula is formed (a pathological channel connecting the focus of inflammation in the region of the lymphatic vessels with the surface of the skin). From the fistula, discharge in the form of chyle (lymph mixed with absorbed digestion products) and fat is possible.
ulcers and necrosis of the skin, abscesses and phlegmon, impaired lymphatic circulation, leading to elephantiasis (enlarged limbs).

It should be noted that there is no immunity after erysipelas, the disease can occur again, and it is impossible to establish whether the disease occurred as a result of the activation of a dormant infection or as a result of a new infection.

Prevention of erysipelas

Compliance with skin hygiene (timely treatment of abrasions, diaper rash, wounds, cracks, pustules).
Strict observance of sanitary and hygienic standards during medical manipulations, processing of medical instruments.
Timely treatment of edema, thrombophlebitis (inflammation of the vein wall with the formation of blood clots that clog the lumen of the vessel).
Timely and sufficient treatment of foci of chronic infection (elimination of carious foci in the oral cavity, treatment of chronic tonsillitis).
In some cases, with a chronic recurrent course of erysipelas, antibiotics of prolonged / long-term action are used for a long time.