Erysipelas is a bacterial infection of the skin and subcutaneous tissue, usually involving the face, ears and lower legs. It is characterized by well demarcated areas of redness, heat, pain, and swelling and may be associated with constitution symptoms including fever, chills, headache, joint pain, and back pain.
Predisposing factors of erysipelas are operative wounds, scrapes, or abrasions of the skin. The onset is usually abrupt with high fever, chills, and weakness. Over the next 24- 48 hours a red shiny plaque forms usually proximal to the area of entry into the skin. A dermatologist can usually make a diagnosis by examining the patient but sometimes other tests including bacterial skin culture, white blood cell count and blood cultures may be needed.
In adults, Group A streptococcal bacterial infection is the most common cause and in children Hemophilus influenza bacterial infection is the most common cause. Treatment for adults is with antibiotics usually a penicillinase – resistant penicillin, cephalosporin, or erythromycin IV or oral depending on the sensitivity. For children less than 3 years old prompt treatment with IV cephalosporins i.e. ceftriaxone is indicated.
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