eMedicine Specialties > Emergency Medicine > Infectious Diseases
Erysipelas: Differential Diagnoses & Workup
Updated: Sep 24, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
| Angioedema | Systemic Lupus Erythematosus |
| Cellulitis | Urticaria |
| Dermatitis, Contact | |
| Herpes Zoster | |
| Necrotizing Fasciitis |
Other Problems to Be Considered
Angioneurotic edema
Dermatophytid
Erysipeloid
Polychondritis
Scarlet fever
Tuberculoid leprosy
Workup
Laboratory Studies
- In general, diagnosis of erysipelas is made clinically. Few laboratory tests are of help in the ED.
- Complete blood count (CBC): Increased WBC with a leftward shift may be observed but is not specific for the diagnosis.
- Blood cultures
- Positive in only 5% of cases
- May be helpful when a question of the diagnosis or concern about bacteremia with metastatic infection exists
- May be of some benefit in patients with prosthetic heart valves or other intravascular devices, artificial joints, or in the immunocompromised or toxic-appearing patient
- Gram stain and culture of rash generally not helpful
- Antistreptolysin (ASO), streptozyme, and anti-DNAase titers may be helpful.
More on Erysipelas |
| Overview: Erysipelas |
Differential Diagnoses & Workup: Erysipelas |
| Treatment & Medication: Erysipelas |
| Follow-up: Erysipelas |
| References |
| « Previous Page | Next Page » |
References
Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med. Jan 25 1996;334(4):240-5. [Medline].
Bonnetblanc JM, Bedane C. Erysipelas: recognition and management. Am J Clin Dermatol. 2003;4(3):157-63. [Medline].
Bratton RL, Nesse RE. St. Anthony's Fire: diagnosis and management of erysipelas. Am Fam Physician. Feb 1 1995;51(2):401-4. [Medline].
Chartier C, Grosshans E. Erysipelas. Int J Dermatol. Sep 1990;29(7):459-67. [Medline].
Elston DM. Epidemiology and prevention of skin and soft tissue infections. Cutis. May 2004;73(5 Suppl):3-7. [Medline].
Jorup-Ronstrom C, Britton S. Recurrent erysipelas: predisposing factors and costs of prophylaxis. Infection. Mar-Apr 1987;15(2):105-6. [Medline].
Krasagakis K, Samonis G, Maniatakis P, Georgala S, Tosca A. Bullous erysipelas: clinical presentation, staphylococcal involvement and methicillin resistance. Dermatology. 2006;212(1):31-5. [Medline].
Swartz MN. Erysipelas. In: Mandell GL, ed, et al. Principles and Practice of Infectious Diseases. 4th ed. Churchill Livingstone; 1995:913-14.
Torok L. Uncommon manifestations of erysipelas. Clin Dermatol. Sep-Oct 2005;23(5):515-8. [Medline].
Lopez FA, Lartchenko S. Skin and soft tissue infections. Infect Dis Clin North Am. Dec 2006;20(4):759-72, v-vi. [Medline].
Morris A. Cellulitis and erysipelas. Clin Evid. Jun 2006;2207-11. [Medline].
Further Reading
Keywords
erysipelas, group A beta-hemolytic streptococci, hemolytic streptococcus, skin infection, painful rash, erythematous rash, edematous rash, abrasions, skin ulcers, insect bites, eczema, psoriatic lesions, lymphatic obstruction, lymphatic edema, saphenous vein grafting in lower extremities, postradical mastectomy, immunocompromised patients, diabetes, alcoholism, arteriovenous insufficiency, paretic limbs
Differential Diagnoses & Workup: Erysipelas