Erysipeloid Workup

  • Author: Zeina Nehme Ghorayeb, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 12, 2012
 

Laboratory Studies

  • Several studies may be requested, depending on the clinical presentation.
  • Gram stain may be performed on a skin scraping, which may show gram-positive rods; however, the stain often is negative because the infection is deep, and the microorganism is not reached with scraping.
  • Bacterial culture on special media fortified with serum and at room temperature may be attempted. Culture of a biopsy from the leading edge of the lesion may reveal the organism.
  • Blood culture aids in the diagnosis of systemic erysipeloid.
  • Skin biopsy may be taken to confirm the diagnosis (see Histologic findings).
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Imaging Studies

  • Imaging studies usually are ordered when an individual has the systemic form of erysipeloid, depending on the clinical presentation and probability of organ involvement.
  • Echocardiography may be ordered, if endocarditis is suspected.
  • CT or MRI of the brain may be used to rule out brain abscess or cerebral infarct.
  • Radiography or CT of the chest may be ordered, if pleural effusion is suspected.
  • Bone scan or MRI of bone may be performed, if osseous necrosis is suspected.
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Histologic Findings

The epidermis shows spongiosis, which may be severe enough to cause intraepidermal vesiculation. Marked edema of the papillary dermis with dilatation of blood and lymphatic vessels occurs. In the reticular dermis, a perivascular inflammatory cell infiltrate made of neutrophils and eosinophils is observed.

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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

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

Shyam Verma is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and 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, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD 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. Aug 8 2009;[Medline].

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

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

  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. May 2003;185(9):2739-48. [Medline].

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

  6. Wang Q, Chang BJ, Riley TV. Erysipelothrix rhusiopathiae. Vet Microbiol. Jan 27 2010;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. Jul 29 2009;[Medline].

  9. Veraldi S, Girgenti V, Dassoni F, Gianotti R. Erysipeloid: a review. Clin Exp Dermatol. Jul 29 2009;[Medline].

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

  11. Barnett JH, Estes SA, Wirman JA, Morris RE, Staneck JL. Erysipeloid. J Am Acad Dermatol. Jul 1983;9(1):116-23. [Medline].

  12. Dunbar SA, Clarridge JE 3rd. Potential errors in recognition of Erysipelothrix rhusiopathiae. J Clin Microbiol. Mar 2000;38(3):1302-4. [Medline].

  13. Gorby GL, Peacock JE Jr. Erysipelothrix rhusiopathiae endocarditis: microbiologic, epidemiologic, and clinical features of an occupational disease. Rev Infect Dis. Mar-Apr 1988;10(2):317-25. [Medline].

 
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