Infectious pathology, which is characterized by damage to the skin and subcutaneous tissue as a result of the penetration of streptococcal infection, is called erysipelas. According to statistics, older men and women are more likely to suffer from it.
General information
The causative agent of the disease enters the damaged skin, as a result, an inflammatory process develops. Immunity after the illness is not formed, so relapses are frequent. Which doctor treats erysipelas? Such a question worries those who are faced with this problem.
When the first signs of the disease are detected, you should contact your local doctor, who, if necessary, will refer you to a surgeon or an infectious disease specialist. There are quite a few complications of the disease (abscess, thrombophlebitis, elephantiasis, necrotic, phlegmonous, erythematous erysipelas) and some of them pose a danger to the life of the individual.
Historical information
Erysipelas disease has been known since ancient times. Many works of Abu Ali Ibn Sina, Hippocrates and other scientists were devoted to the diagnosis and treatment of this disease. InIn the second half of the nineteenth century, cases of outbreaks of erysipelas in maternity hospitals and surgical hospitals were described. At that time it was believed that this pathology is highly contact. For the first time, a pure culture of streptococcus was obtained by the scientist Feleizen I. in 1882 from a patient with erysipelas. Further study of the pathogenetic mechanisms and epidemiological features, as well as the effect of the ongoing therapy with sulfonamides and antibiotics, changed the idea of this disease. In Soviet times, erysipelas was also actively studied.
Main factors in the development of erysipelas
Causes of erysipelas:
- constant contact with pollution or chemicals;
- allergic reactions;
- dermatological diseases (contact dermatitis, neurodermatitis);
- viral diseases of the dermis (herpes);
- skin damage: cracks, various wounds, including from the installation of a catheter or other medical devices, insect bites, navel wounds in newborns;
- lymphostasis;
- presence of chronic pathologies: otitis media, diabetes mellitus, chronic tonsillitis;
- lowered immunity.
Clinical picture of erysipelas
The incubation period of erysipelas (ICD-10: A46) is short, inflammation develops rapidly.
At the initial stage, the following symptoms appear:
- body temperature rises to 39 degrees, which lasts up to ten days;
- appears chills, weakness;
- aches joints and bones;
- possibleconvulsions;
- clouding of consciousness (rare);
- attacks of nausea or vomiting.
On the first day of illness, places where there are wounds and scars swell, turn red, there is a burning sensation and pain. Lymph nodes located near the affected area enlarge and become painful. Blisters and hemorrhages may form in the wound area.
Further, the disease progresses, the symptoms increase. Apathy develops, sleep is disturbed. The affected area becomes hot, painful, edematous, dense to the touch with clear curved borders resembling flames. Lymph nodes are painful, hard, and limit mobility. From the site of the lesion to the lymph nodes, a strip of pale pink staining appears. Possible increase in pressure, tachycardia. After a few days (about seven), the temperature decreases, the affected area becomes paler, the swelling subsides, the size of the lymph nodes decreases, and there is peeling of the dermis.
Is erysipelas contagious or not? It is contagious to others throughout the entire period of therapy.
Different localizations of erysipelas
Erysipelas of the face. It develops both during the primary and secondary episodes of the disease.
When the forehead, cheeks and nose are affected at the same time, significant visible changes are observed, the face is distorted. Puffiness of the eyelids during inflammation leads to a narrowing of the palpebral fissures. In some cases, the patient cannot open his eyes. Submandibular lymph nodes enlarge and become painful.
Erysipelas of the scalp. Severe pain in the area of inflammation is noted. There is infiltration, redness is rare.
Erysipelas of upper limbs. Rarely diagnosed. Postoperative lymphostasis of the arm in women after surgery to remove a breast tumor is a predisposing cause of erysipelas.
Erysipelas of the genitals and perineum. There is extensive swelling of the scrotum and penis in men, labia majora in women. Erythema is localized on the abdomen and pubic region, rarely on the thighs and buttocks.
Erysipelas of mucous membranes. Occurs rarely. The most dangerous is erysipelas of the epiglottis and pharynx.
Types of erysipelas
- Wandering or migrating. In this case, the infection spreads through the blood lymph. The lower extremities are primarily affected. The duration of the course is up to several months.
- Metastatic. Inflammatory foci are formed in remote places from the primary localization. The reason is the hematogenous spread of streptococcal infection.
- Periodic. Develops during menstruation. There are regular relapses during menopause.
- Recurrent. Occurs frequently. Localization of inflammation is observed at the site of the primary lesion. Remission lasts from several weeks to two years. The development of chronic recurrent erysipelas is promoted by improper treatment, diseases of the dermis of a chronic nature (mycoses), the presence of streptococcal infection in the body, frequent hypothermia, microtrauma.
- Repeated. Diagnosed two years after the primary with a different localization.
- Erysipelas Vikhrov or "gelatinous" recurrent. It develops against the background of elephantiasis. Erythema is mild, there is no clear boundary between he althy and affected dermis.
- Rosenberg-Unna's white mug. It is detected in patients with leprosy, tuberculosis, syphilis and other diseases. It is manifested by a sharp swelling of the dermis, soreness. Erythema is absent due to squeezing of blood vessels and intense exudation in the lymph nodes.
Treatment
Immediately after diagnosis, treatment of this disease should begin. First of all, the doctor prescribes antibiotics for erysipelas:
- Amoxicillin.
- Ceftriaxone.
- "Bicillin". This drug is also used for prevention.
In addition to antibiotics, doctors prescribe the following groups of medicines:
- antipyretic;
- antihistamines;
- sulfonamides, and in case of intolerance to antibiotics, these are the drugs of choice;
- immunostimulants.
For compresses apply:
- Furacillin.
- "Dimexide".
- "Enteroseptol".
Make them until the wound surface is completely healed every day.
Recommended ointments for erysipelas:
- Levomekol. Used as an independent tool.
- Naftalan. Used in conjunction with physiotherapy.
Timely and correctthe selected therapy leads to a complete recovery. The way of life with this disease does not differ from the usual. For preventive purposes, it is recommended to keep the skin clean. If abrasions, wounds or cracks form, treat them with antiseptic agents.
Folk ways
Treatment of erysipelas at home is possible only after consultation with your doctor. Kombucha is considered the most popular remedy.
Moisten a piece of gauze with a well-infused and filtered solution and wipe the affected area. Using medicinal plant materials, for example, coltsfoot, you can make a compress. Apply it daily or alternating with the drug "Levomekol". In addition, some doctors recommend various homeopathic remedies, both for the treatment of erysipelas and its relapses. However, we must remember that the use of the above methods gives a good effect only in combination with traditional therapy.
Preventive measures
These include:
- personal hygiene;
- treatment of damaged areas of the dermis with antiseptic agents;
- timely treatment of fungal infections of the feet, nails;
- immunity maintenance;
- wearing loose cotton clothing;
- he alth promotion;
- diabetic patients, follow all doctor's recommendations;
Important: a prerequisite for the formation of a dangerous form of the disease, namely gangrenous erysipelasinflammation, is diabetes.
When a relapse occurs, doctors recommend antibacterial agents to prevent secondary infections. For these purposes, the drug "Bicillin" is usually prescribed. The scheme and duration of its administration is determined by the attending physician and depends on the frequency of relapses.
The whole complex of measures for the prevention of erysipelas is aimed at protecting the body from the pathogen.
Baby's erysipelas
According to statistics, boys get this infectious skin disease less often than girls. The disease is characterized by seasonality, and infection occurs mainly in the autumn-summer period. Some selective predisposition or even susceptibility to this streptococcal infection that affects soft tissues is noted. In some children, after the illness, an unstable immunity is formed, and they can get sick repeatedly. The route of transmission of the disease erysipelas or infection with streptococcus occurs:
- through damaged mucous membranes or dermis;
- when using contaminated medical devices or dressing materials;
- if there is a streptococcal focus of infection in the body.
The incubation period lasts from several hours to five days. In children who often suffer from this disease, hypothermia and stress are a prerequisite for its development.
Signs of disease in children
Erysipelas disease begins acutely, a significant development of intoxication is in the initial stage. These symptoms precede the first signs of the disease from several hours to days. During this period, the baby appears:
- general malaise;
- muscle pain syndrome;
- chill;
- vomit;
- nausea;
- hypothermia;
- in areas of the dermis, where local manifestations of the disease subsequently appear, pain, burning, and bursting are observed.
The disease progresses quite quickly. Local reactions appear immediately after reaching the peak of fever and intoxication of the body. The most common location for erysipelas is the lower extremities. Initially, a small pink or red spot is formed, which after a few hours takes on a specific appearance. The dermis in the affected area is edematous, hot to the touch, painful on palpation, the existing blisters are filled with fluid and may burst. In their place, yellowish-brown marks remain, which eventually disappear.
Therapy in children
With a mild form of erysipelas and no complications, treatment is carried out on an outpatient basis. Hospitalization is indicated in the following cases:
- small child age;
- frequent relapses;
- presence of serious comorbidities;
- heavy course.
For treatment, courses of antibiotics are prescribed. In erysipelas, different groups are used: macrolides, fluoroquinolones, tetracyclines, combined and broad-spectrum drugs. In case of intolerance, antibiotics are prescribed for ten days.courses "Furazolidone" and "Delagil". In hospital conditions, drugs of the penicillin group, aminoglycosides and cephalosporins are used. If necessary, carry out detoxification therapy. Regardless of where the child is being treated, according to medical indications, they are prescribed:
- vitamin complexes;
- antipyretics;
- anti-inflammatory drugs;
- diuretics;
- cardiovascular drugs;
- physiotherapy treatment.
Prevention measures
In order to prevent erysipelas in children, parents should follow some recommendations:
- avoid injury and abrasion of the lower extremities;
- with frequent relapses, carry out prophylaxis with antibacterial drugs that can stop the spread of infection in the child's body;
- if a staphylococcal infection is detected, treat it in a timely manner.
The duration of the medication is determined by the attending doctor.
Erysipelas in newborns
In babies, this pathology develops very quickly. Initially, the navel is affected, then the infection spreads throughout the body, capturing the joints and limbs. An intoxication syndrome develops. Erysipelas with lesions of the nose and ears is quite rare. In these cases, a complication in the form of meningitis almost always develops. Perhaps the development of pathology against the background of diaper rash. When pregnant with erysipelas, the fetus develops septic intrauterine infection.
Erysipelas onleg
It is manifested by inflammation of the skin of the lower extremities. Most of all, individuals who work in unsanitary conditions, who are outdoors for a long time, are susceptible to it. As a result, contact with dust and dirt occurs, which contributes to the entry of streptococcal infection into the body.
The place where the pathological process appeared becomes hot and turns red. Delayed treatment is fraught with serious complications. There are several ways of penetration of staphylococcus, as well as the reasons for the development of this pathology:
- injuries;
- burns;
- insect bites;
- combing;
- chronic tonsillitis;
- untreated caries;
- lowered immunity;
- regular cold feet;
- stress situations;
- excess UV;
- thrombophlebitis or varicose veins of the lower extremities;
- ulcerative lesions;
- alcoholism.
Causes of disease
After the incubation period, initial signs begin to appear:
- general weakness;
- temperature increase;
- severe headaches;
- nausea;
- vomit;
- diarrhea;
- muscles feel sore and tired.
Local manifestations appear immediately or after a day.
Forms of the inflammatory process
There are several forms of erysipelas:
- Erythematous. The affected area acquires a reddish even shade, has clearborders, the shape of the edges of the spot is incorrect.
- Erythematous-bullous. Unlike the previous form, after two days the dermis begins to exfoliate and blisters form, inside of which there is a colorless liquid. When the bubble bursts, a crust forms in its place, which has a light brown color. If the disease is not treated, then the blisters, corroding the skin, form trophic ulcers.
- Erythematous-hemorrhagic. This form differs from the above in that hemorrhages may occur on the affected areas.
- Bullous-hemorrhagic. Unlike erythematous bullous blisters, they fill with blood.
Treatment of erysipelas on leg
At the first sign of illness, you should contact your local doctor. Self-medication is strictly not recommended. Treatment of erysipelas can be carried out in both inpatient and outpatient settings. In all severe cases, the patient is hospitalized in the surgical department of the hospital. The following groups of drugs are prescribed for therapy:
- antibacterial;
- sulfanilamide;
- anti-inflammatory;
- diuretic;
- vascular;
- vitamins A, B, C;
- angioprotectors.
Of the physiotherapy procedures, the most effective for erysipelas on the leg are:
- ultraviolet irradiation;
- laser therapy;
- exposure to high-frequency current.
Alternative medicine
Folkrecipes:
- Leaves of coltsfoot and chamomile flowers, taken in equal parts, mixed with honey. Treat the affected area with the resulting composition. Do not use if allergic to bee products.
- Prepare a mixture of sour cream and chopped burdock leaf. Apply to the damaged area of the skin.
- Prepare an infusion of plantain leaves, add honey. Treat the affected areas with the resulting solution.
- Treating the diseased area with pork fat every two hours will help reduce inflammation.
- Crush the chalk and sprinkle it on the sore spot of the dermis, apply a compress. The procedure is carried out before going to bed. This method is considered very effective.
In closing
All pathologies caused by streptococcal infection, if left untreated, can lead to serious consequences. The disease of erysipelas in this case is no exception. Complications of the disease: blood poisoning, abscesses, phlegmon, thrombophlebitis, elephantiasis. Thus, only qualified medical assistance provided in a timely manner will help to successfully cope with this disease.
