Erysipelas is an infectious disease with general intoxication of the body and inflammatory skin lesions. The causative agent is streptococcus erysipelas, it is stable outside the human body, tolerates drying and low temperatures well, dies when heated to 56C for 30 minutes. The source of the disease is the patient and the carrier. Contagiousness (infectiousness) is insignificant. The disease is registered in the form of individual cases.
Infection occurs mainly when the integrity of the skin is violated by contaminated objects, tools or hands.
- erythematous form in the form of redness and swelling of the skin;
- hemorrhagic form with the phenomena of permeability of blood vessels and their bleeding;
- bullous form with blisters on inflamed skin filled with serous exudate.
Symptoms and course of erysipelas . The incubation period is from 3 to 5 days. The onset of the disease is acute, sudden. On the first day, the symptoms of general intoxication are more pronounced (severe headache, chills, general weakness, nausea, vomiting, and an increase in temperature to 39-40C are possible).
erythematous form. After 6-12 hours from the onset of the disease, there is a burning sensation, bursting pain, redness (erythema) and swelling on the skin at the site of inflammation. The area affected by erysipelas is clearly separated from the healthy one by an elevated, sharply painful roller. The skin in the focus area is hot to the touch, tense. If there are small punctate hemorrhages, then they talk about the erythematous-hemorrhagic form of erysipelas. With bullous erysipelas against the background of erythema, in various periods after its appearance, bullous elements are formed – blisters containing a clear and transparent liquid. Later, they subside, forming dense brown crusts, which are rejected after 2-3 weeks. Erosions and trophic ulcers can form at the site of the blisters. All forms of erysipelas are accompanied by lesions of the lymphatic system – lymphadenitis, lymphangitis.
Primary erysipelas are more often localized on the face, recurrent – on the lower extremities.
There are early relapses (up to 6 months) and late (over 6 months). Concomitant diseases contribute to their development. Of greatest importance are chronic inflammatory foci, diseases of the lymphatic and blood vessels of the lower extremities (phlebitis, thrombophlebitis, varicose veins); diseases with a pronounced allergic component (bronchial asthma, allergic rhinitis), skin diseases (mycoses, peripheral ulcers). Relapses also appear as a result of the action of unfavorable professional factors.
Duration of the disease: local manifestations of erythematous erysipelas disappear by the 5-8th day of the disease, in other forms they can last more than 10-14 days. Residual manifestations of erysipelas – pigmentation, peeling, pastosity of the skin, the presence of dry dense crusts in place of bullous elements. Perhaps the development of lymphostasis, leading to elephantiasis of the limbs.
Erysipelas treatment.Depends on the form of the disease, its multiplicity, the degree of intoxication, the presence of complications. Etiotropic therapy: antibiotics of the penicillin series in average daily dosages (penicillin, tetracycline, erythromycin or oleandomycin, oletethrin, etc.). Less effective are sulfonamide products, combined chemical products (bactrim, septin, biseptol). The course of treatment is traditionally 8-10 days. With frequent persistent relapses, tseporin, oxacillin, ampicillin and methicillin are recommended. It is desirable to conduct 2 courses of antibiotic therapy with a change of products (intervals between courses 7-10 days). With often recurrent erysipelas, corticosteroids are used at a daily dosage of 30 mg. With persistent infiltration, non-steroidal anti-inflammatory drugs are indicated – chlotazol, butadione, reopyrin, etc. It is advisable to prescribe ascorbic acid, rutin, vitamins of group B. Autohemotherapy gives good results. In the acute period of the disease, the focus of inflammation is indicated by the appointment of UVI, UHF, followed by the use of ozokerite (paraffin) or naftalan. Local treatment of uncomplicated erysipelas is carried out only with its bullous form: a bulla is incised at one of the edges and dressings with a solution of rivanol, furacilin are applied to the focus of inflammation. Subsequently, dressings with ectericin, Shostakovsky’s balm, and manganese-vaseline dressings are prescribed. Local treatment alternates with physiotherapeutic procedures. a bulla is incised at one of the edges and bandages with a solution of rivanol, furacilin are applied to the focus of inflammation. Subsequently, dressings with ectericin, Shostakovsky’s balm, and manganese-vaseline dressings are prescribed. Local treatment alternates with physiotherapeutic procedures. a bulla is incised at one of the edges and bandages with a solution of rivanol, furacilin are applied to the focus of inflammation. Subsequently, dressings with ectericin, Shostakovsky’s balm, and manganese-vaseline dressings are prescribed. Local treatment alternates with physiotherapeutic procedures.
The prognosis is favorable.
Prevention of erysipelas in persons susceptible to this disease is difficult and requires careful treatment of concomitant diseases of the skin, peripheral vessels, as well as sanitation of foci of chronic streptococcal infection. Erysipelas does not give immunity, there is a special high susceptibility of all those who have been ill.