Differentiating erysipelas from other diseases
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Erysipelas must be differentiated from other inflammatory dermatological conditions that present with pain, erythema, edema, and blisters of the skin - in conjunction with other systemic conditions such as fever, chills, fatigue, headache, and vomiting.
Differentiating Erysipelas from other Diseases
Erysipelas must be differentiated from other inflammatory dermatological conditions that present with pain, erythema, edema, and blisters of the skin - in conjunction with other systemic conditions such as fever, chills, fatigue, headache, and vomiting.[1]
| Disease | Findings |
|---|---|
| Cellulitis | Presents with nearly identical symptoms to Erysipelas, and is also usually caused by Streptococcus or Staphlycoccus bacteria.[2]Differentiates from Erysipelas in that it manifests beneath the epidermis in the dermal layer of the skin; infection can spread to the subcutaneous fat, bones, joints and muscles of the affected area. The area of inflammation is not as sharply visibly demarcated as those characteristic of Erysipelas, due to the deeper manifestation in the skin. Can lead to worse complications than Erysipelas, including osteomyelitis, lymphangitis, endocarditis, and meningitis. |
| Necrotizing fasciitis | Presents with more severe epidermal signs and symptoms than Erysipelas. Necrotizing fasciitis usually presents with erythema, edema, blisters, pain, suppuration, and clear signs of tissue necrosis (dark violet/blue to black in appearance).[3] Left untreated, necrotizing fasciitis usually leads to subcutaneous nerve destruction; a patient communicating more pain than is visibly apparent or manifested on the epidermis is indicative of nerve damage preceding or disproportionate to visible evidence.[4] |
| Shingles | Presents with fever, weakness, cough, nasal congestion, dizziness, and post-nasal drip. Nasal congestion can result in feelings of "fullness" in the middle ear that can manifest similarly to otitis media. Sinusitis differentiates from otitis media in that there is usually no ear pain or suppurative discharge or tympanic effusion.[5] |
| Angioedema | Presents with severe dizziness, tinnitus, hearing loss, and feelings of "fullness" in the inner ear[6]. Usually affects individuals between aged 40 and 60 years old. Caused by buildup of fluid in the inner ear. Differentiates from otitis media in that there is usually no ear pain or suppurative discharge, as well as no common cold symptoms.[7] |
| Contact dermatitis | Presents with fever, weakness, cough, nasal congestion, dizziness, and post-nasal drip. Nasal congestion can result in feelings of "fullness" in the middle ear that can manifest similarly to otitis media. Sinusitis differentiates from otitis media in that there is usually no ear pain or suppurative discharge or tympanic effusion.[5] |
| Breast cancer | Presents with fever, weakness, cough, nasal congestion, dizziness, and post-nasal drip. Nasal congestion can result in feelings of "fullness" in the middle ear that can manifest similarly to otitis media. Sinusitis differentiates from otitis media in that there is usually no ear pain or suppurative discharge or tympanic effusion.[5] |
References
- ↑ Inghammar M, Rasmussen M, Linder A (2014). "Recurrent erysipelas--risk factors and clinical presentation". BMC Infect. Dis. 14: 270. doi:10.1186/1471-2334-14-270. PMC 4033615. PMID 24884840.
- ↑ "Cellulitis: MedlinePlus Medical Encyclopedia".
- ↑ "Necrotizing soft tissue infection: MedlinePlus Medical Encyclopedia".
- ↑ Sadasivan J, Maroju NK, Balasubramaniam A (2013). "Necrotizing fasciitis". Indian J Plast Surg. 46 (3): 472–8. doi:10.4103/0970-0358.121978. PMC 3897089. PMID 24459334.
- ↑ 5.0 5.1 5.2 "Sinusitis: MedlinePlus".
- ↑ "Ménière's Disease | NIDCD".
- ↑ "Meniere's Disease: MedlinePlus".