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Erysipeloid

  • Author: Zeina Nehme Ghorayeb, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jul 17, 2014
 

Background

Erysipeloid is an acute bacterial infection of traumatized skin and other organs. Erysipeloid is caused by the microorganism Erysipelothrix rhusiopathiae (insidiosa), which long has been known to cause animal and human infections. Direct contact between meat infected with E rhusiopathiae and traumatized human skin results in erysipeloid. In animals, the organism causes swine erysipelas and several other diseases in poultry and sheep.[1]

Erysipeloid is an occupational disease.[2, 3] Humans acquire erysipeloid after direct contact with infected animals. Erysipeloid is more common among farmers, butchers, cooks, homemakers, and anglers. The infection is more likely to occur during the summer or early fall.

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Pathophysiology

E rhusiopathiae, which is highly resistant to environmental factors, enters the skin through scratches or pricks. In the skin, the organism is capable of producing certain enzymes that help it dissect its way through the tissues. It has recently been discovered that only pathogenic strains of E rhusiopathiae are capable of producing the neuraminidase enzyme. This enzyme is speculated to help the microorganism invade tissues. Moreover, 2 adhesive surface proteins were discovered and their nucleotide sequence encoded. The proteins are named RspA and RspB and serve in helping the microorganism bind to biotic (collagen types I and IV) and abiotic (polystyrene) surfaces.[4, 5]

Meanwhile, the host's immune system is activated to start fighting against this foreign bacterium. The organism may escape immune surveillance and may spread in the body via the vascular system to the joints, heart, brain, CNS, and lungs. The organ most commonly affected other than the skin is the heart.

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Epidemiology

Frequency

International

Infection with E rhusiopathiae occurs in worldwide distribution in a variety of animals, especially hogs.

Mortality/Morbidity

Erysipeloid usually is an acute, self-limited infection of the skin that resolves without consequences. Individuals with the systemic form of erysipeloid, in which organs other than the skin are involved, may have neurologic, cardiologic, or other impairments. Individuals with systemic infection may even die of sepsis, if the proper diagnosis is not made and treatment is not initiated early on.

Race

No racial predilection is recognized for erysipeloid.

Sex

Both sexes may be equally affected; however, erysipeloid seems to affect more males than females because of occupational exposure.

Age

Erysipeloid can affect any age group.

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Contributor Information and Disclosures
Author

Zeina Nehme Ghorayeb, MD Lecturer, University of Balamand School of Medicine

Zeina Nehme Ghorayeb, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Coauthor(s)

Mona Matta-Muallem, MD Associate Professor, Department of Dermatology, American University of Beirut, Lebanon

Mona Matta-Muallem, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Shyam Verma, MBBS, DVD, FAAD Clinical Associate Professor, Department of Dermatology, University of Virginia School of Medicine; Adjunct Associate Professor, Department of Dermatology, State University of New York at Stonybrook School of Medicine; Adjunct Associate Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Shyam Verma, MBBS, DVD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
  1. Wang Q, Chang BJ, Riley TV. Erysipelothrix rhusiopathiae. Vet Microbiol. 2009 Aug 8. [Medline].

  2. Brooke CJ, Riley TV. Erysipelothrix rhusiopathiae: bacteriology, epidemiology and clinical manifestations of an occupational pathogen. J Med Microbiol. 1999 Sep. 48(9):789-99. [Medline].

  3. Reboli AC, Farrar WE. Erysipelothrix rhusiopathiae: an occupational pathogen. Clin Microbiol Rev. 1989 Oct. 2(4):354-9. [Medline]. [Full Text].

  4. Shimoji Y, Ogawa Y, Osaki M, et al. Adhesive surface proteins of Erysipelothrix rhusiopathiae bind to polystyrene, fibronectin, and type I and IV collagens. J Bacteriol. 2003 May. 185(9):2739-48. [Medline].

  5. Wang Q, Chang BJ, Mee BJ, Riley TV. Neuraminidase production by Erysipelothrix rhusiopathiae. Vet Microbiol. 2005 May 20. 107(3-4):265-72. [Medline].

  6. Wang Q, Chang BJ, Riley TV. Erysipelothrix rhusiopathiae. Vet Microbiol. 2010 Jan 27. 140(3-4):405-17. [Medline].

  7. Tomaszuk-Kazberuk A, Kaminska M, Sobkowicz B, Hirnle T, Prokop J, Lewczuk A, et al. Infective endocarditis caused by Erysipelothrix rhusiopathiae involving three native valves. Kardiol Pol. 2011. 69(8):827-9. [Medline].

  8. Veraldi S, Girgenti V, Dassoni F, Gianotti R. Erysipeloid: a review. Clin Exp Dermatol. 2009 Dec. 34(8):859-62. [Medline].

  9. Fidalgo SG, Longbottom CJ, Rjley TV. Susceptibility of Erysipelothrix rhusiopathiae to antimicrobial agents and home disinfectants. Pathology. 2002 Oct. 34(5):462-5. [Medline].

  10. Barclay L. IDSA: skin and soft tissue infections guidelines updated. Medscape Medical News. Available at http://www.medscape.com/viewarticle/827399. Accessed: June 26, 2014.

  11. [Guideline] Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of america. Clin Infect Dis. 2014 Jul 15. 59(2):e10-52. [Medline]. [Full Text].

 
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