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KAVITA NATHAN Group 318

ERYSIPELAS. KAVITA NATHAN Group 318. what is erysipelas ?. It is a streptococcal infection of the superficial lymphatic vessels, usually associated with broken skin on the face. The area affected is erythematous and oedematous.

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KAVITA NATHAN Group 318

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  1. ERYSIPELAS KAVITA NATHAN Group 318

  2. what is erysipelas ? • It is a streptococcal infection of the superficial lymphatic vessels, usually associated with broken skin on the face. • The area affected is erythematous and oedematous. • The patient may be febrile and have a leucocytosis.

  3. Erysipelas on face

  4. pathophysiology Bacteria inoculation into an area of skin, trauma is the initial event in the developing erysipelas

  5. In erysipelas, the infection rapidly invades and spreads through the lymphatic vessels. This can produce overlying skin "streaking" and regional lymph node swelling and tenderness. Immunity does not developto the inciting organism.

  6. Regional lymphnode swelling and tenderness

  7. RISK FACTORS INCLUDE: • A cut in the skin • Problem with drainage through the veins or lymph system • Skin sores( ulcers)

  8. Predisposing Factors

  9. Stasis ulceration:

  10. Venous insufficiency

  11. Surgical incisions

  12. Diabetic foot

  13. Lymphedema

  14. Nephrotic syndrome

  15. causes • Streptococcal toxins are thought to contribute to the brisk inflammation that is pathognomonic of this infection. • they clearly coexist with streptococci at sites of inoculation.

  16. Recently, atypical forms reported to be caused by : • * Streptococcus pneumoniae, • *Klebsiella pneumoniae, • * Haemophilus influenzae, • *Yersinia enterocolitica, • *Moraxella species,

  17. Causative agent • *Streptococciare the primary cause of erysipelas. • * Most facial infections are attributed to group Astreptococci, • *lower extremity infections being caused by non–group A streptococci.

  18. Erysipelas: related medical condition

  19. Group A beta- hemolytic streptocci • Hemolytic streptococcus • Skin infection • Painful rashes Erythematous rash • Edematous rash • Skin ulcer • Abrasions • Skin ulcer • Insect bite • eczema

  20. clinical

  21. symptoms • Blisters • Fever, shaking, and chills • Painful, very red, swollen, and warm skin underneath the sore (lesion) • Skin lesion with a raised border • Sores (erysipelas lesions) on the cheeks and bridge of the nose

  22. physical

  23. Erysipelas begins as a small erythematous patch that progresses to a fiery-red, indurated , tense, and shiny plaque

  24. The lesion classically exhibits raised sharply demarcated advancing margins. • Local signs of inflammation • warmth, • edema, • tenderness are universal.

  25. Lymphatic involvement often is manifested by overlying skin streaking and regional lymphadenopathy

  26. More severe infections may exhibit numerous vesicles and bullae along with petechiae and even frank necrosis.

  27. Erysipelas can occur in different region

  28. Erysipelas on face

  29. Erysipelas on leg

  30. Erysipelas in buttock region

  31. Signs and test • Erysipelas is diagnosed based on how the skin looks. A biopsy of the skin is usually not needed.

  32. Differential diagnoses • 1) Erythema Annulare Centri-fugum2) Stasis Dermatitis • 3) Cellulitis • 4) Erysipeloid

  33. Erythema annulare centrifugum * Eruptions occur at any age.

  34. Lesions most often appear on the thighs, legs, face, trunk and arms. linked to underlying diseases , viral , bacterial or even tumor.

  35. Stasis dermatitis

  36. cellulitis

  37. erysipeloid

  38. * acute bacterial infection of traumatized skin. • * caused by Erysipelothrixrhusiopathiae(gram positive rod-shaped bacterium), which cause animal and human infections. • * Direct contact between infected meat and traumatized human skin results in Erysipeloid. • more common among farmers, butchers, cooks, homemakers. • * Lesions most commonly affect the hands.

  39. treatment

  40. Antibiotics such as penicillin are used to eliminate the infection. In severe cases, antibiotics may need to be given through an IV (intravenous line). • Those who have repeated episodes of erysipelas may need long-term antibiotics.

  41. Medical care • * Elevation and rest of the affected limb are recommended to reduce local swelling, inflammation, and pain. • * Saline wet dressings should be applied to ulcerated and necrotic lesions and changed every 2-12 hours, depending on the severity of the infection.

  42. *A first-generation cephalosporin or macrolide, such as erythromycin or azithromycin, may be used if the patient has an allergy to penicillin.

  43. Two new drugs: roxithromycin & pristinamycin, have been reported to be extremely effective in the treatment of erysipelas.

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