Erysipelas

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.