Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- 17 Fever and Rash
- 18 Staphylococcal and Streptococcal Toxic Shock and Kawasaki Syndromes
- 19 Classic Viral Exanthems
- 20 Skin Ulcer and Pyoderma
- 21 Cellulitis and Erysipelas
- 22 Deep Soft-Tissue Infections: Necrotizing Fasciitis and Gas Gangrene
- 23 Human and Animal Bites
- 24 Lice, Scabies, and Myiasis
- 25 Superficial Fungal Diseases of the Hair, Skin, and Nails
- 26 Mycetoma (Madura Foot)
- 27 Fever and Lymphadenopathy
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
21 - Cellulitis and Erysipelas
from Part IV - Clinical Syndromes – Skin and Lymph Nodes
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- 17 Fever and Rash
- 18 Staphylococcal and Streptococcal Toxic Shock and Kawasaki Syndromes
- 19 Classic Viral Exanthems
- 20 Skin Ulcer and Pyoderma
- 21 Cellulitis and Erysipelas
- 22 Deep Soft-Tissue Infections: Necrotizing Fasciitis and Gas Gangrene
- 23 Human and Animal Bites
- 24 Lice, Scabies, and Myiasis
- 25 Superficial Fungal Diseases of the Hair, Skin, and Nails
- 26 Mycetoma (Madura Foot)
- 27 Fever and Lymphadenopathy
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Skin and soft-tissue infections (SSTIs) are routinely encountered by physicians in the office setting and can vary in both clinical presentation and severity. Erysipelas is a more superficial SSTI involving the dermal lymphatics; cellulitis is a deeper infection extending into the deep dermis and subcutaneous tissues.
ERYSIPELAS
Clinical Manifestations
Erysipelas is a superficial SSTI with dermal lymphatic involvement and a distinct clinical presentation. The legs are the most common affected sites, but erysipelas can occur anywhere on the body. Young, elderly, and immunocompromised patients are particularly susceptible to erysipelas, especially if predisposing factors such as venous insufficiency, lymphedema, obesity, or any epidermal defect that impairs barrier function (eg, ulcers, operative or traumatic wounds, fissures) exist. Erysipelas is more common in older women and young men.
Erysipelas classically presents as a tender, sharply demarcated, bright-red edematous plaque with a raised, indurated advancing border (Figure 21.1). Abrupt onset of fever, chills, and malaise may precede skin disease by a few hours to a day. Some patients have associated regional lymphadenopathy with or without lymphatic streaking, in addition to edema with possible bullae formation.
Because erysipelas can produce lymphatic obstruction, it tends to recur in areas of earlier infection. Such recurrences are the most common complication occurring in approximately 30% of cases. Other complications including sepsis and progression to deep cellulitis are uncommon and are usually restricted to debilitated patients with underlying diseases.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 151 - 156Publisher: Cambridge University PressPrint publication year: 2008
- 1
- Cited by