Erysipelas: Symptoms, Causes, and Treatment Overview

Erysipelas: Symptoms, Causes, and Treatment Overview

An erysipelas, or erysipelas or erysipelas, is a skin infection that usually occurs on the leg, especially the foot or lower leg, or the face. The symptoms include a sharply defined reddening of the affected area, pain, fever, and a general feeling of illness. The cause of erysipelas is a bacterial attack, often due to a minor skin injury, such as an athlete’s foot or an insect bite. Without early treatment with antibiotics, the infection can have serious consequences.

What is erysipelas?

An erysipelas (erysipelas or erysipelas) is an acute skin infection caused by bacteria (usually streptococci), which generally only affects the upper layers of the skin. If the soft tissue infection spreads to deeper connective tissue and even to tendons or muscles, this is referred to as phlegmon.


Symptoms: what does erysipelas look like?

The typical symptoms of erysipelas include an intense, shiny, flame-shaped reddening of the skin, which is limited and not purulent. The jagged form of the reddening of the skin is caused by the spread of the infection along the lymphatic vessels. Within a short time, the inflammation spreads across the area around the entry point of the pathogen. Although erysipelas can appear anywhere on the body, erysipelas often develop on the leg (especially the foot and lower leg), face, arm, or navel.

The following side effects of erysipelas are possible:

  • general malaise and tiredness
  • Burning, itching, tightness or overheating of the skin
  • painful, tender swelling of the affected area
  • Joint and headache or body aches
  • Fever
  • Shivering to the point of chills
  • nausea
  • Swelling of nearby lymph nodes
  • Blisters or bumps, minor bleeding

The symptoms mentioned can, but do not have to be associated with erysipelas. Even an inconspicuous course without clearly visible redness and side effects is possible. Mainly, when erysipelas occur repeatedly, the cold-like symptoms often do not happen. In the early stages, the flu-like side effects or pain in the affected area sometimes only appear before visible symptoms appear.

Erysipelas: how is the diagnosis made?

In the case of erysipelas, a doctor can often make the diagnosis based on the visible symptoms and physical complaints of the person concerned. A part of diagnostics is always searching for the entry point of the pathogen, for example, a wound or fungal infection.

In addition, a survey or examination of any risk factors, i.e., simultaneous or previous illnesses, can promote erysipelas. In addition, a blood test or (rarely) a swab can supplement the diagnosis and help to determine the extent of the inflammation or the exact pathogen. So-called leukocytosis, i.e. an increased number of leukocytes (white blood cells) and increased inflammatory parameters in the blood (CRP value), are typical of erysipelas.


differentiation from other diseases

A central part of diagnosing erysipelas is the differentiation from other diseases. These include, among others:

  • Shingles ( herpes zoster)
  • Phlegmon (a purulent inflammation, often resulting from a wound or ulcer)
  • non-infectious inflammation in chronic venous insufficiency (on the lower leg)
  • Phlebitis or venous thrombosis in the leg
  • Redness at the edge of the wound as part of wound healing
  • Borreliosis ( erythema )
  • allergic reaction (contact dermatitis)
  • necrotizing fasciitis

In addition, a distinction must also be made in the linguistic sense: erysipelas on the face are referred to as “facial erysipelas”. This term can also mean shingles on the face.

erysipelas: course and consequences

During erysipelas, the pathogens spread along the lymphatic gaps and vessels, where they trigger inflammation with which the body tries to fight the bacteria. If erysipelas is not treated early enough or insufficient, there is a risk of severe consequences. The pathogens spread quickly in the body and can cause various complications.

Possible complications of erysipelas include:

  • Hemorrhages and blisters in the upper layers of the skin
  • Clogging of the lymphatic system (lymphatic swelling or lymphedema up to elephantiasis nostras)
  • phlebitis
  • Thrombosis
  • Spread into deeper skin layers (phlegmon)
  • sepsis (blood poisoning)
  • Inflammation of the inner wall of the kidney or heart (endocarditis)
  • Inflammation of the meninges (meningitis) or thrombosis of the cerebral veins is a rare consequence of facial erythema

If erysipelas reappear in the same place after it has subsided, this is a relapse or recurrence. This is exceptionally high if additional risk factors such as diabetes or venous diseases are present.

Erysipelas: Early therapy with antibiotics

Early treatment of erysipelas usually allows it to heal after a few days of illness. Thorough cleaning and care of the entry point of the germ is also essential as part of the therapy to avoid relapses. Among other things, cooling, antiseptic compresses or antibiotic ointments are used.

The treatment of erysipelas usually involves an antibiotic, usually penicillin. The drug is given as a tablet or intravenously, depending on the severity of the infection. This may sometimes require inpatient treatment in a hospital.

How long erysipelas lasts depends on the severity of the infection. If the treatment requires a stay in the hospital, this lasts about a week. Antibiosis, i.e. treatment with antibiotics, usually lasts 10 to 14 days. Long-term administration of antibiotics helps with chronic erysipelas.


Further measures for erysipelas

In addition to the administration of antibiotics, the following measures are available to treat erysipelas:

  • anti-inflammatory and antipyretic pain relievers such as ibuprofen
  • Syringes with heparin to prevent thrombosis
  • Lymphatic drainage if lymphatic congestion persists after the erysipelas have healed
  • A compression bandage or support stockings prevent fluid from accumulating in the tissue again after the swelling in the affected area has gone down.

The extent of the reddening of the skin is often marked with a pen to monitor its course.

Tips for treating erysipelas

Anyone suffering from erysipelas should move the affected area as little as possible so the infection does not spread. Bed rest can, therefore, be recommended for immobilization but also increases the risk of thrombosis. Those affected should also keep these tips in mind:

  • If you have erythema, avoid speaking and chewing movements, such as eating strained food.
  • If your arms or legs are affected, you should raise them to improve lymphatic drainage.
  • Cool the affected area. But be careful: Excessive cooling could impede blood flow in the vessels.
  • You can use skin creams to prevent your skin from becoming dry and cracked.

Even if many people prefer homoeopathy, erysipelas is a severe illness that always requires a doctor’s visit and must be treated with antibiotics. Homoeopathic ointments can only be used to help combat the swelling.

Causes: How do you get erysipelas?

Erysipelas is an acute bacterial skin disease usually caused by streptococci (rarely by staphylococci).

The bacteria often already live on the skin and enter the body through minor skin injuries to multiply in the upper layers of the skin. As a result, the skin is swelling and red in the affected areas.

Such portals of entry in the skin often arise due to minor injuries, such as a scratch, an insect bite or a cut or abrasion. But cracked skin, torn corners of the mouth, eczema, skin diseases such as neurodermatitis or fungal infections such as athlete’s foot are also possible triggers for erysipelas. In addition, the bacteria can also get into the skin through more significant injuries such as animal bites or as a result of an operation.

Erysipelas are not contagious in the usual sense: the pathogens can be transmitted from person to person. However, undamaged skin and a healthy immune system can usually fight off the bacteria. Therefore, there is typically no risk of infection.


Risk factors for erysipelas

People with a weakened immune system, for example, as a result of surgery or by taking immunocompromising medication, as well as children and the elderly, are particularly susceptible to the disease. Certain diseases also increase the risk of developing erysipelas. For example:

  • lymphedema
  • Diabetes mellitus
  • Leg swelling and vein diseases
  • circulatory disorders

prevent erysipelas

You cannot avoid erysipelas altogether, but you can prevent it by minimizing the risk factors. If you suffer from a disease-promoting erysipelas, treat it well.

Check yourself regularly for injuries, especially to the legs. Professional pedicure is recommended, especially if you have diabetes so that your feet can be examined and cared for by experts. If you suspect erysipelas, seek medical advice immediately.

Regular foot care can also help prevent athlete’s foot and nail fungus . If the skin is injured, clean and disinfect it carefully to prevent erysipelas.

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