Erysipelas Treatment in South Africa

It is a superficial type of cellulitis, a potentially severe bacterial infection, which affects the skin.

Erysipelas afflicts the upper dermis and advances into the superficial cutaneous lymphatics. It's also called St. Anthony's fire, with reference to the severe rash related to it.

Causes of erysipelas?

Erysipelas is often caused by group A Streptococcus bacteria. The disease might affect both adults and kids.

Some conditions which may result in erysipelas are:

• A cut in the skin
• Issues with drainage through the lymph or vein system.
• Skin sores (ulcers)

The infection takes place on the legs in most cases. It can as well occur on the face.

Who is at risk?

Erysipelas mostly affects babies and the senior, but may affect any age group. Risk factors are much like those for other types of cellulitis. They might include:

• Previous episode(s) of erysipelas
• Breaks in the skin barrier because of ulcers, insect bites and chronic skin disorders like eczema, psoriasis and athlete’s foot
• Prior or Present injury ( eg radiotherapy, trauma, surgical wounds)
• In infants, vaccination site injury and exposure of the umbilical cord
• Nasopharyngeal infection
• Venous condition (e.g. leg ulceration, gravitational eczema) and/or lymphoedema
• Immune deficiency or compromise, like
  • Diabetes
  • Alcoholism
  • Obesity
  • Human immunodeficiency virus ( HIV )
• Nephrotic syndrome
• Pregnancy

Symptoms

• fever
• chills
• usually feeling sick
• a painful, red, and inflamed section of skin with an elevated edge
• blisters on the affected area
• inflamed glands
• Sores on the bridge and cheeks of the nose

What are the complications of erysipelas?

Erysipelas recurs in up to one-third of patients because of:

• Persistence of risk factors
• Lymphatic damage (thus impaired drainage of toxins)

Complications are uncommon but may consist of:

• Abscess
• Gangrene
• Thrombophlebitis
• Chronic leg inflammation
• Infections distant to the site of erysipelas:
  • Infective endocarditis (heart valves)
  • Septic arthritis
  • Bursitis
  • Tendonitis
• Post-streptococcal glomerulonephritis (a kidney condition disease, which affects kids)
• Cavernous sinus thrombosis (hazardous blood clots which can extend to the brain)
• Streptococcal toxic shock syndrome (rare)

How is erysipelas diagnosed?

 Erysipelas is often diagnosed by the characteristic rash. There's usually a history of a relevant injury. Examinations might disclose:

• Raised white cell count
• Raised C-reactive protein
• Positive blood culture identifying the organism

CT and MRI are performed in the event of deep infection.

What is the treatment for erysipelas?

General

• Analgesics and cold packs to ease local discomfort
• Elevation of an infected limb to decrease local inflammation
• Compression stockings
• Wound care using saline dressings, which are with saline dressings regularly changed

Antibiotics

• Intravenous or oral penicillin is the antibiotic of first choice.
• Pristinamycin, Erythromycin or roxithromycin can be used in patients with penicillin allergy • Vancomycin is used for facial erysipelas due to MRSA

Treatment is often for 10–14 days

For many people, antibiotics will effectively treat erysipelas within one week. But it might take more than one week for the skin to get back to normal, and peeling might take place in the affected areas. Those who have persisted episodes of erysipelas might require long-term preventive antibiotic treatment.

Without treatment, you might be susceptible to numerous complications, which include:

• an abscess
• blood clots
• gangrene that refers to the death of body tissue
• blood poisoning, it occurs when the infection spreads all through your bloodstream
• infected heart valves
• Bone and joint bone infections

How Can Erysipelas Be Prevented?

Though erysipelas cannot often be prevented, you can take the following measures to reduce your risk:

• Always keep wounds clean.
• Treat athlete’s foot in case you have it.
• Use moisturizing creams to prevent skin from drying and cracking.
• Try not to scratch your skin.
• Make Ensure any skin conditions, like eczema, are addressed effectively.

When to consult a doctor

 Contact your health care provider if you have a skin sore and other the signs of erysipelas.