Erysipelas
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Erysipelas is a type of cellulitis (bacterial skin infection) that extends into the superficial cutaneous lymphatics. The most common bacteria responsible are group A streptococci. Infection occurs via inoculation into an area of local skin trauma; the legs are most commonly affected, but the face may also be infected. Patients may complain of headache, arthralgia/myalgia, and/or nausea. In severe infections, vesicles, bullae, petechiae, and frank necrosis may be found.
The diagnosis is typically clinical.
Treatment
Treatment for 10-20 days is recommended with penicillin (or a first-generation cephalosporin or macrolide in penicillin-allergic patients). Elevation and rest of the affected area may help reduce swelling.
Cap/syp Amoxicillin+Floxacillin 500mg 1cap TDS or
Tab/syp Amoxicillin+Clavulanic acid)625mg 1 Tab PO TDS
Saline wet dressings should be applied to ulcerated and necrotic lesions.
Debridement may be required in severe cases with necrosis or gangrene. Non-steroidal anti-inflammatory drugs are contra-indicated (risk of necrotizing fasciitis).
Hospitalize for the following: children younger than 3 months, critically ill appearing patient, local complications, debilitated patient (chronic conditions, the elderly) or if there is a risk of non-compliance with or failure of -outpatient treatment.