Erysipeloid

Updated: Apr 18, 2017
  • Author: Marc Zachary Handler, MD; Chief Editor: Dirk M Elston, MD  more...
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Overview

Background

Erysipeloid is an acute bacterial infection of traumatized skin and other organs. Erysipeloid is caused by the non–spore-forming, non–acid-fast, gram-positive rod microorganism, Erysipelothrix rhusiopathiae (insidiosa), which long has been known to cause animal and human infections. Direct contact between meat infected with E rhusiopathiae and traumatized human skin results in erysipeloid. In animals, the organism causes swine erysipelas and several other diseases in poultry and sheep. [1]

Erysipeloid is an occupational disease. [2, 3] Humans acquire erysipeloid after direct contact with infected animals. Erysipeloid is more common among farmers, butchers, cooks, homemakers, and anglers. The infection is more likely to occur during the summer or early fall. See the image below.

Erysipeloid. Courtesy of DermNet New Zealand (http Erysipeloid. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/erysipeloid/) and the Waikato District Health Board (http://www.waikatodhb.health.nz/).
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Pathophysiology

E rhusiopathiae, which is highly resistant to environmental factors, enters the skin through scratches or pricks. In the skin, the organism is capable of producing certain enzymes that help it dissect its way through the tissues. It has recently been discovered that only pathogenic strains of E rhusiopathiae are capable of producing the neuraminidase enzyme. This enzyme is speculated to help the microorganism invade tissues. Moreover, 2 adhesive surface proteins were discovered and their nucleotide sequence encoded. The proteins are named RspA and RspB and serve in helping the microorganism bind to biotic (collagen types I and IV) and abiotic (polystyrene) surfaces. [4, 5]

Meanwhile, the host's immune system is activated to start fighting against this foreign bacterium. The organism may escape immune surveillance and may spread in the body via the vascular system to the joints, heart, brain, CNS, and lungs. [6] The organ most commonly affected other than the skin is the heart.

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Epidemiology

Frequency

Infection with E rhusiopathiae occurs in worldwide distribution in a variety of animals, especially hogs.

Race

No racial predilection is recognized for erysipeloid.

Sex

Both sexes may be equally affected; however, erysipeloid seems to affect more males than females because of occupational exposure.

Age

Erysipeloid can affect any age group.

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Prognosis

Erysipeloid usually is an acute, self-limited infection of the skin that resolves without consequences.

Cutaneous forms of erysipeloid usually are self-limited even without treatment; therefore, skin-limited erysipeloid has a fairly good prognosis with no long-term sequelae.

Individuals with the systemic form of erysipeloid, in which organs other than the skin are involved, may have neurologic, cardiologic, or other impairments. Individuals with systemic infection may even die of sepsis, if the proper diagnosis is not made and treatment is not initiated early on. Prognosis of the systemic form of erysipeloid depends on the organ systems involved and on the extent of involvement. Early recognition and proper initiation of therapy is crucial to prevent sequelae.

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Patient Education

Instruct patients to be cautious while handling animals and animal products.

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