Erysipelas - acute streptococcal disease characterized by lesions
the skin to form a sharply limited the inflammatory focus, as well as
fever and symptoms of intoxication, frequent relapses.
Pathogen - hemolytic streptococcus - nothing
no different from the pathogen to other streptococcal diseases
(E.g., angina). It penetrates through small skin lesions.
Perhaps exogenous infection (contaminated instruments,
dressing). In the occurrence of erysipelas relapses in one and the
same place counts allergic alteration and skin sensitization
to hemolytic streptococci.
Symptoms of erysipelas
The duration of the incubation period
several hours to five days (usually 3-4 days). By the nature of the local
distinguish lesions erythematous, erythematous-bullous,
erythematous-hemorrhagic and bullous form, severity - mild,
moderate and severe, by the multiplicity - primary, recurrent and
re, localization of local events - localized,
advanced and metastatic. Primary erysipelas begins,
usually acute, with symptoms of intoxication. Body temperature
rises to 39-40gr. Since, there are general weakness, chills, headache,
, myalgia (muscle pain), in severe cases can be convulsions, delirium, irritation
After 10-24 hours of onset observed local
symptoms: pain, burning sensation and a feeling of tension in the affected area of skin,
during the inspection revealed redness and swelling of the skin. Erythema (redness of the skin strong) most uniform,
towering above the skin. Swelling is particularly pronounced in
localization of inflammation of the eyelids, lips, fingers, genitals.
Sometimes the background of erythema formation of bubbles filled with serous
(Zritematozno-bullous) or hemorrhagic (bullous-hemorrhagic
mug) content. There are also regional lymphangitis and inflammation
lymph node. At the site of inflammation in the future there
peeling of the skin. Local changes are kept 5-15 days; can be long
pastoznost persist and skin pigmentation.
Relapses faces can occur in a period of a few days up to 2
years after the disease. At a later date (over 2 years)
the appearance of faces talking about re-face. It is usually localized to the
new skin site. Retsidiairovaniyu contribute to the lack of treatment
primary faces, residual effects after erysipelas (lymphostasis et al.). at
frequent relapses of fever and intoxication symptoms are mild.
Complications and consequences of faces may be the same as for
other streptococcal diseases (rheumatism, nephritis, myocarditis), but
there may be specific to faces:
ulcers and skin necrosis (gangrenous erysipelas), abscesses and cellulitis
(Abscessed mug), violation of lymph circulation, which leads to
elephantiasis. If you need to differentiate between the clinical diagnosis of
other diseases where localized redness may occur
and swelling of the skin (vein thrombosis, erizipiloid, cellulitis and abscesses, acute
dermatitis and others.). In the study of blood was small
leukocytosis, neutrophilia, increased erythrocyte sedimentation rate. Immunity after faces no
Treatment, prognosis and prevention of erysipelas
Treatment. The most effective antibiotics penicillin.
In the face of the primary and rare relapses prescribed dose of penicillin 500
000 units at 6 hours for 7-10 days, at the end of the course further
introduced bicillin 5 (1500000 IU / m). With significant residual
phenomena for the prevention of recurrence bicillin 5 must be entered in the
for 4-6 months (at 1 500 000 units in 4 weeks). When intolerance
Erythromycin can be administered penicillin (0.3 g of 5 times a day) or
tetracycline (at 0.3-0.4 g 4 times a day), the length of the course of 7-10 days.
When persistent and frequent relapses antibiotics combined with
corticosteroids (prednisolone 30 mg / day).
Weather favorable. If often recurrent erysipelas may elephantiasis, breaking capacity for work,
Preventing injuries and abrasions feet, treatment of streptococcal
diseases. When pronounced seasonality of recurrence spend
bitsillinoprofilaktiku that starts a month before the start of the season and
continue for 3-4 months (administered every 4 weeks bicillin 5 for 1500
000 IU). With frequent recurrences of erysipelas is performed year-round
bitsillinoprofilaktiku. Activities in the outbreak is not carried out. specific