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 (necrotizing fasciitis)[3]
- Osteoarticular complications, including bursitis, osteitis, tendinitis, and arthritis[4]
- Bacteremia, resulting from spread of infection from the epidermis to the bloodstream.[5]
- Septic shock[6]
- Chronic, recurrent Erysipelas due to increased susceptibility from damaged cutaneous lymph vessels[7]
- Meninigitis if the infection is localized in the face and spreads below the dermis and into the brain and spinal cord
- Gangrene
- Acute glomerulonephritis[8]
- Thrombophlebitis[9]
- Lymphatic damage and lymphedema[2]
- Streptococcal toxic shock syndrome[1]
Prognosis
References
- ↑ 1.0 1.1 Ferretti JJ, Stevens DL, Fischetti VA, Stevens DL, Bryant AE. PMID 26866211. Missing or empty
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(help) - ↑ 2.0 2.1 "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.
- ↑ Coste N, Perceau G, Léone J, Young P, Carsuzaa F, Bernardeau K, Bernard P (2004). "Osteoarticular complications of erysipelas". J. Am. Acad. Dermatol. 50 (2): 203–9. doi:10.1016/S0190. PMID 14726873.
- ↑ "Erysipelas: MedlinePlus Medical Encyclopedia".
- ↑ "Septic shock: MedlinePlus Medical Encyclopedia".
- ↑ Koster JB, Kullberg BJ, van der Meer JW (2007). "Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies". Neth J Med. 65 (3): 89–94. PMID 17387234.
- ↑ Velciov S, Gluhovschi G, Feier V, Curescu M, Trandafirescu V, Petrică L, Gluhovschi C, Bob F, Bozdog G, Gadalean F, Florescu C, Bobu M, Chiliban A (2010). "Elements of renal injury in patients with erysipelas". Rom J Intern Med. 48 (2): 179–85. PMID 21428183.
- ↑ Gunderson CG, Chang JJ (2013). "Risk of deep vein thrombosis in patients with cellulitis and erysipelas: a systematic review and meta-analysis". Thromb. Res. 132 (3): 336–40. doi:10.1016/j.thromres.2013.07.021. PMID 23948644.