Giới thiệu
- An acute spreading skin infection that may go deep, involving the subcutaneous tissues
- Typically occurs in areas where the skin integrity has been compromised
- May also result from blood-borne spread of infection to the skin and subcutaneous tissues
Definition
Erysipelas
- A type of cellulitis with sharply demarcated margins involving the epidermis and superficial lymphatics
- Onset of symptoms is acute whereas cellulitis has an indolent course
- More commonly caused by beta-hemolytic streptococci
Nguyên nhân
- Commonly caused by beta-hemolytic streptococci and Staphylococcus aureus in adults, and Haemophilus influenzae type B in patients <3 years
- Infection due to streptococci is rapidly spreading because of streptokinase while that of staphylococci is localized
- Consider Methicillin-resistant S aureus (MRSA) in patients with recurrent cellulitis, or refractory to treatment
- Can also be caused by Streptococcus pneumoniae, Gram-negative bacilli and anaerobes
Uncomplicated Cellulitis
- Beta-hemolytic streptococcal etiology in 90% of infections but S aureus is difficult to exclude especially if mixed infection occurs
Complicated Cellulitis
- Group A streptococci, S aureus, H influenzae B, Enterobacteriaceae and anaerobes
Signs and Symptoms
- Rapidly spreading area of acute inflammation of the dermis and subcutaneous tissue
- Lymphangitis and inflammation of the regional lymph nodes may occur
- Area is usually tender, erythematous and warm to the touch
- Patient may have malaise, fever and chills
Yếu tố nguy cơ
- Obesity
- Diabetes mellitus and malignancy
- Immunosuppression
- Previous cutaneous damage
- Edema from venous insufficiency or lymphatic obstruction