Erysipelas natural history, complications and prognosis
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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
Natural History
- Erysipelas onset begins shortly after streptococcal infection.[1]
- An initial lesion forms with localized erythema and edema
- Advancing from the initial location is rapid, with raised and sharply demarcated boundaries from surrounding unaffected tissue.
- Untreated, the lesions will spread, while the initial manifestation resolves.
- Systemic symptoms, including fever, chills, and vomiting may occur as the inflammation persists and spreads.
- If left untreated, Erysipelas will not usually be self-resolved and can lead to life-threatening complications.[2]
Complications
Complications of Erysipelas occur if the infectious pathogen is not treated, including the following:
- Increased severity of lesions, including haemorrhagic, bullous, abscessing and necrotic[3]
- Spread of infection to other areas of body through the bloodstream (bacteremia), including septic arthritis and infective endocarditis (heart valves).
- Septic shock.
- Recurrence of infection – Erysipelas can recur in 18-30% of cases even after antibiotic treatment.
- Lymphatic damage
- Necrotizing fasciitis -- AKA "the flesh-eating bug." A potentially-deadly exacerbation of the infection if it spreads to deeper tissue.
Prognosis
References
- ↑ Ferretti JJ, Stevens DL, Fischetti VA, Stevens DL, Bryant AE. PMID 26866211. Missing or empty
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(help) - ↑ "Erysipelas and cellulitis: Overview - National Library of Medicine - PubMed Health".
- ↑ Krasagakis K, Samonis G, Valachis A, Maniatakis P, Evangelou G, Tosca A (2011). "Local complications of erysipelas: a study of associated risk factors". Clin. Exp. Dermatol. 36 (4): 351–4. doi:10.1111/j.1365-2230.2010.03978.x. PMID 21198795.