Erysipelas.

Mónica Caetano, Isabel Amorin

Abstract


Erysipelas is an acute dermo-hypodermal infection (non necrotizing) of bacterial origin, mainly group A beta-haemolytic streptococcus. The lower limbs are affected in more than 80% of the cases and the identified risk factors are disruption of cutaneous barrier, lymphoedema and obesity. Diagnosis is clinical and based upon the association of an acute inflammatory plaque with fever, lymphangitis, adenopathy and leukocytosis. Bacteriology is usually not helpful because of low sensitivity or delayed positivity. In the atypical forms erysipelas must be distinguished from necrotizing fasciitis and acute vein thrombosis. Penicillin remains the gold standard treatment, although new drugs, given their pharmacodynamic profile, may be used. Recurrence is the main complication, being crucial the correct treatment of the risk factors.

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