Erysipelas in Emergency Medicine 

  • Author: Geofrey Nochimson, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Apr 14, 2011
 

Background

Erysipelas is a skin infection typically caused by group A beta-hemolytic streptococci, although other streptococcal groups are occasionally causative agents. Infection involves the dermis and lymphatics and is a more superficial subcutaneous infection of the skin than cellulitis. Erysipelas is characterized by intense erythema, induration, and a sharply demarcated border, which differentiates it from other skin infections.[1]

Next

Pathophysiology

The skin is the primary organ system affected.

Previous
Next

Epidemiology

Frequency

United States

Increasing incidence has been noted since the late 1980s.

Mortality/Morbidity

Erysipelas generally is benign; however, it can be fatal when associated with bacteremia in very young, elderly, or immunocompromised patients. The mortality rate is less than 1% in treated cases. Associated comorbidities include hypertension, diabetes mellitus, chronic venous insuffienciency, and other cardiovascular diseases.[2]

Sex

Slight female predominance is observed. This was confirmed in a study of hospitalized patients by Pereira de Godoy et al.[2]

Age

Infection occurs at extremes of age, but erysipelas is primarily a disease of adults.

Previous
Proceed to Clinical Presentation
 
 
Contributor Information and Disclosures
Author

Geofrey Nochimson, MD  Consulting Staff, Department of Emergency Medicine, Sentara Careplex Hospital

Geofrey Nochimson, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francis Counselman, MD  Program Director, Chair, Professor, Department of Emergency Medicine, Eastern Virginia Medical School

Francis Counselman, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Association of Academic Chairs of Emergency Medicine (AACEM), Norfolk Academy of Medicine, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Eddy S Lang, MDCM, CCFP(EM), CSPQ  Associate Professor, Senior Researcher, Division of Emergency Medicine, Department of Family Medicine, University of Calgary; Assistant Professor, Department of Family Medicine, McGill University

Eddy S Lang, MDCM, CCFP(EM), CSPQ is a member of the following medical societies: American College of Emergency Physicians, Canadian Association of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References

  1. Bonnetblanc JM, Bedane C. Erysipelas: recognition and management. Am J Clin Dermatol. 2003;4(3):157-63. [Medline].

  2. Pereira de Godoy JM, Galacini Massari P, Yoshino Rosinha M, et al. Epidemiological data and comorbidities of 428 patients hospitalized with erysipelas. Angiology. Jul 2010;61(5):492-4. [Medline].

  3. Morris AD. Cellulitis and erysipelas. Clin Evid (Online). Jan 2 2008;2008:[Medline].

  4. Bernard P. Management of common bacterial infections of the skin. Curr Opin Infect Dis. Apr 2008;21(2):122-8. [Medline].

  5. Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med. Jan 25 1996;334(4):240-5. [Medline].

  6. Bratton RL, Nesse RE. St. Anthony's Fire: diagnosis and management of erysipelas. Am Fam Physician. Feb 1 1995;51(2):401-4. [Medline].

  7. Chartier C, Grosshans E. Erysipelas. Int J Dermatol. Sep 1990;29(7):459-67. [Medline].

  8. Elston DM. Epidemiology and prevention of skin and soft tissue infections. Cutis. May 2004;73(5 Suppl):3-7. [Medline].

  9. Jorup-Ronstrom C, Britton S. Recurrent erysipelas: predisposing factors and costs of prophylaxis. Infection. Mar-Apr 1987;15(2):105-6. [Medline].

  10. 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].

  11. Krasagakis K, Valachis A, Maniatakis P, et al. Analysis of epidemiology, clinical features and management of erysipelas. Int J Dermatol. Sep 2010;49(9):1012-7. [Medline].

  12. Lopez FA, Lartchenko S. Skin and soft tissue infections. Infect Dis Clin North Am. Dec 2006;20(4):759-72, v-vi. [Medline].

  13. Morris A. Cellulitis and erysipelas. Clin Evid. Jun 2006;2207-11. [Medline].

  14. Pereira de Godoy JM, Galacini Massari P, Yoshino Rosinha M, et al. Epidemiological data and comorbidities of 428 patients hospitalized with erysipelas. Angiology. Jul 2010;61(5):492-4. [Medline].

  15. Swartz MN. Erysipelas. In: Mandell GL, ed, et al. Principles and Practice of Infectious Diseases. 4th ed. Churchill Livingstone; 1995:913-14.

  16. Torok L. Uncommon manifestations of erysipelas. Clin Dermatol. Sep-Oct 2005;23(5):515-8. [Medline].

 
Previous
Next
 
Facial erysipelas exhibiting classic fiery-red plaque with raised, well-demarcated borders.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.