eMedicine Specialties > Emergency Medicine > Infectious Diseases
Erysipelas: Follow-up
Updated: Sep 24, 2008
Follow-up
Further Outpatient Care
- Patients with erysipelas should have a follow-up visit with primary care 24-48 hours after ED visit, unless symptoms are clearly improving and other problems have not developed.
Inpatient & Outpatient Medications
- Antibiotics
- Analgesics
- Antipyretics
Complications
Complications of erysipelas may include the following:
- Gangrene/amputation
- Bacteremia sepsis
- Scarlet fever
- Pneumonia
- Abscess
- Embolism
- Meningitis
- Death
Prognosis
- Excellent, if treated properly in patients with intact immune systems
- Chronic edema
- Scarring
- Elephantiasis from chronic, recurrent cases (rare)
- May resolve spontaneously, even when untreated
Patient Education
- Instruct patients to rest, elevate affected area, and use warm compresses 4 times a day for 48 hours. Patients should return or see primary care physician if experiencing an increase in pain, fever and chills, redness, or other new symptoms.
Miscellaneous
Medicolegal Pitfalls
- Erysipelas may lead to serious morbidity and even mortality; therefore, for the clinician to recognize this illness and begin timely, appropriate treatment, and ensure necessary follow-up is critical.
- Appropriate antibiotics should be initiated as soon as possible; ensure patient has means to obtain antibiotics once discharged from ED.
Special Concerns
- Hospitalization recommended in patients who are toxic, have severe disease with immunocompromise, or are unlikely to complete course of treatment for psychosocial or economic reasons
- Significant underlying diseases
- Extremes of age
More on Erysipelas |
| Overview: Erysipelas |
| Differential Diagnoses & Workup: Erysipelas |
| Treatment & Medication: Erysipelas |
 Follow-up: Erysipelas |
| References |
| « Previous 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
