Erysipeloid Treatment & Management
- Author: Zeina Nehme Ghorayeb, MD; Chief Editor: Dirk M Elston, MD more...
The antibiotics of choice for the 3 forms of erysipeloid is penicillin or cephalosporin. Ceftriaxone proved to have an effect against Erysipelothrix rhusiopathiae. In patients who are allergic to penicillin, ciprofloxacin alone or erythromycin in combination with rifampin may be used. The microorganism is resistant to vancomycin, an important consideration in patients with endocarditis caused by E rhusiopathiae.
E rhusiopathiae has been shown to be eradicated from surfaces by the use of simple home disinfectants; thus, an important step in the prevention of infection may be to spray hazardous work areas (eg, fishing boats, meat counters) with disinfectants.
The Infectious Diseases Society of America recently updated their guidelines for the diagnosis and management of skin and soft tissue infections. For the full guidelines, see Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America.[10, 11]
See the list below:
Procedures usually are not used in the cutaneous form of erysipeloid. Even a simple incision and drainage of lesions is not recommended as this may prolong the recovery time.
Individuals with the systemic form of erysipeloid may undergo surgery (eg, cardiac valve replacement), pleural tap, or other procedures, depending on extent of organ involvement.
See the list below:
An infectious disease specialist may be consulted when deciding treatment, especially in cases of bone and joint involvement.
Opinions from a cardiologist and cardiothoracic surgeon are mandatory in cases of endocarditis.
Pulmonologists are consulted in cases of pleural effusion.
Neurologists and neurosurgeons are consulted when presence of CNS disease.
Activity usually is not restricted. Individuals with the systemic form of erysipeloid may be advised to be on bed rest.
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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].
Wang Q, Chang BJ, Mee BJ, Riley TV. Neuraminidase production by Erysipelothrix rhusiopathiae. Vet Microbiol. 2005 May 20. 107(3-4):265-72. [Medline].
Wang Q, Chang BJ, Riley TV. Erysipelothrix rhusiopathiae. Vet Microbiol. 2010 Jan 27. 140(3-4):405-17. [Medline].
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].
Veraldi S, Girgenti V, Dassoni F, Gianotti R. Erysipeloid: a review. Clin Exp Dermatol. 2009 Dec. 34(8):859-62. [Medline].
Fidalgo SG, Longbottom CJ, Rjley TV. Susceptibility of Erysipelothrix rhusiopathiae to antimicrobial agents and home disinfectants. Pathology. 2002 Oct. 34(5):462-5. [Medline].
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.
[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].