Appeared red spots on the body, few people attach great importance. People rush to seek medical help if these spots quickly increase in size, provoke a fever, cause severe pain and other negative symptoms. This is how erysipelas of the auricle manifests itself, and among the people it’s just an ear erysipelas. This name of the disease has nothing to do with the slang use of the word "face". It is taken from the Polish language, in translation from which it means a red rose. Is redness of the auricle dangerous for a person? What causes it? Do I need to treat erysipelas on the ear? All the features of the disease are described in this article.
Pathogen
Ears can become red for various reasons. It is not always a disease. Even in cases where our hearing organs suddenly begin to burn and itch, this may not be related to the disease. However, the symptoms of erysipelas of the external ear are so characteristic that when they appear, you should not hesitate to consult a doctor. Erysipelas is a very serious infectious disease caused bystreptococci. Many varieties of these bacteria are known. All of them are pathogenic. However, some do not pose a great threat to human he alth and life, and do not even require specific treatment.
Erysipelas of the ear and other parts of the body provokes a group of streptococci belonging to microbes of the beta-hemolytic type, that is, those that completely destroy red blood cells. There are 20 groups of beta-hemolytic streptococci. Faces are caused by representatives of group A, which are considered the most dangerous for humans. They are the causative agents of scarlet fever, tonsillitis, bronchitis, rheumatism, pericarditis and myocarditis, pharyngitis, pneumonia, fasciitis. People who fall ill with these ailments are sources of microbes that can be transmitted by airborne, household, transplacental and alimentary routes.
In addition, group A beta-hemolytic streptococci are found in some quantities on the skin of each of us. As long as our immunity has the power to suppress their growth, they do no harm. These microorganisms can cause disease when any injuries appear on the skin.
A feature of these microbes is their low resistance to environmental factors. This means that they quickly die when sanitizing medical instruments and following the rules of personal hygiene.
Causes of disease
Before considering the symptoms and treatment of erysipelas, let's get acquainted with the causes of this disease. It may be primary orrecurrent.
From the above information, it is clear that the penetration of the pathogen into the skin of the auricle or a part of the body located in close proximity to it is possible through various skin lesions, even the most minor. They may occur in the following situations:
- Ear piercing.
- Scratch (for example, with a fingernail).
- Combing (common in eczema, insect bite).
- Squeezing a pimple.
- Strike.
- Frostbite or burn.
- Cleaning the ear with items that are not intended for this.
However, violations of the integrity of the skin do not always lead to erysipelas. For this to happen, bacteria must enter the wound. They are transmitted in the following ways:
- From a person who has any of the diseases caused by group A beta-hemolytic streptococci. Most often it is tonsillitis, bronchitis, pharyngitis. Microbes get from the sick to the he althy by airborne droplets.
- Through household items shared between sick and he althy.
- A person who has, for example, a sore throat, can infect his ear with his own hands if streptococci have got on them from the oral cavity.
- When using non-sterile instruments during any manipulations (surgery, piercing).
These are the most likely routes of transmission for streptococci. In rare cases, the infection spreads through the hematogenous or lymphogenous routes.
The primary occurrence of erysipelas of the ear largely depends on the strengthhuman immunity. Those whose body is weakened by disease, surgery, malnutrition, stress, hard physical work, are more likely to get erysipelas, as their immunity is not able to resist bacteria.
Streptococcal inflammation can initially begin in the area of the auricle, and then spread to the face and skin under the scalp. But another course of development is also possible, when inflammation initially occurs on the face, neck, on the head under the hair, and then goes to the ear.
Classification
Erysipelas can be:
- Primary.
- Repeat.
- Recurrent.
According to the severity of the leak, its degrees are distinguished:
- Easy.
- Average.
- Heavy.
The following forms of erysipelas are distinguished by the nature of localized manifestations:
- Erythematous. Erythema is formed, that is, redness and swelling of the skin.
- Erythematous-hemorrhagic. Bleeding occurs at the site of erythema due to damage to blood vessels.
- Erythematous-bullous. Blisters filled with exudate appear.
- Bullous-hemorrhagic. With this form, the blisters are not filled with transparent, but with bloody exudate.
Symptomatics
It's hard not to immediately recognize the symptoms of erysipelas. Treatment of the disease should be professional and comprehensive. This is the only way to completely get rid of the disease. Otherwise, recurrent forms of erysipelas are formed. Symptoms of recurrence are about the same asprimary disease. The incubation period can last from a couple of hours to five days. The majority of patients are able to name not only the day of the onset of the disease, but also the hour, because its first symptoms are extremely acute:
- Heat temperature.
- Chills, fever.
- Unbearable headache.
- Nausea.
- Dizziness.
- Weakness.
- Sometimes there may be loss of consciousness, delirium.
- Some people have unpleasant sensations in the ear, but the patients cannot yet describe them exactly. Some people think that water got into the ear, others - that something is bursting there.
- Myalgic syndrome.
Usually, after 10-20 hours from the onset of the onset of the first signs of the disease, local symptoms appear that can capture only part of the auricle (lobe, tragus) or the entire outer ear. This is:
- Itching.
- Redness.
- Increase in temperature in the inflamed area.
- Soreness (cannot be touched).
- Often the skin in this place begins to shine.
- Edema.
- In the bullous form, blisters appear on the affected areas with a clear liquid inside. Later, erosion and trophic ulcers form in their place.
All patients with erysipelas are diagnosed with lymphadenitis and lymphangitis (inflammation of the lymphatic vessels and nodes).
In addition, patients may experience tachycardia, arterial hypotension, heart soundsbecome muted.
Diagnosis
If the patient seeks medical help before the appearance of local symptoms, the doctor must differentiate erysipelas of the external ear from other diseases that have similar symptoms. If the patient's condition is severe (he has a high fever, vomiting, dizziness, delirium), he is hospitalized.
At the initial stage of the disease, the doctor collects an anamnesis, conducts a general examination of the skin, mucous membranes of the oral cavity, measures pressure. Also, blood is taken from the patient for a general analysis in order to get a picture of the state of leukocytes, platelets and erythrocytes.
If the patient already has signs of inflammation of the auricle when going to the hospital, it is necessary to differentiate erysipelas from other skin diseases, such as phlegmon, abscess, erysipeloid, eczema, dermatitis, otitis media and others.
Great help in making a diagnosis is the sudden acute onset of the disease, which is a characteristic sign of erysipelas.
The doctor must conduct an external examination of the ear. With erysipelas, at the moment of pressing a finger on the hyperemic area, the redness disappears. In addition, any touch to the problem area causes severe pain. This is one of the differences between erysipelas and eczema, in which such sensitivity is not observed.
Then, using special instruments, the doctor performs an otoscopy of the ear canal to assess its condition.
An important sign of erysipelas is that with this disease there is a clearthe border between the affected area and the he althy one (no gradual transition, blurring of the borders).
If there is discharge from the ear, samples are taken for analysis.
Methods of treating erysipelas of the ear
Therapy of this disease necessarily includes a course of antibiotics. Streptococci of the hemolytic type are highly sensitive to sulfonamides, penicillin drugs, nitrofurans, which makes it easier for doctors. The course could be:
- Drugs of choice: Erythromycin, Clindamycin, Oleandomycin, Ampicillin trihydrate. Patients are prescribed these drugs orally or intramuscularly. Treatment is carried out for 5-7 days.
- Drugs of different groups, prescribed in one course, are effective, for example, "Phenoxymethylpenicillin" and "Furazolidone".
- "Biseptol" (reception 7-10 days).
- Antihistamines.
- Vitamins.
- Non-steroidal anti-inflammatory drugs.
- In severe cases of the disease, biostimulants are prescribed (Levamisole, Methyluracil).
- In special cases, placental gamma globulin is introduced into the course, plasma and blood transfusions are performed.
Also carry out therapy locally. It consists in applying anti-inflammatory ointments (for example, "Ichthyol"), sprinkling the affected areas with Enteroseptol powder.
With such enhanced treatment, the next day (sometimes on the second or third day) there is a significant improvement. The patient's temperature drops to normal, the hyperemia of the auricle decreases, and the general condition improves.
Erysipelas of the ear in children, symptoms and treatment of the disease
In young patients, the disease manifests itself in the same way as in adults. The reasons for its occurrence are identical. This is the penetration of group A streptococci in places of damage to the skin of the auricle. The child definitely needs to carry out hygiene procedures for the ears.
Parents should remember that the baby's hearing organs are very delicate, and their size is much smaller than that of adults. Therefore, it is necessary to clean the child's ears carefully, using suitable devices for this. So, for infants, this procedure is carried out using a cotton pad rolled into a tourniquet, and for children up to a year old, with cotton swabs with a limiter at the end. If you do not follow these rules, you can easily damage not only the outer ear, but also the eardrum.
It is also necessary to ensure that water does not get into the ears of the children when bathing.
Children, by negligence, can injure their ears with any object (twig, pencil, pen).
In some cases, the hearing aid can injure the skin.
An important role in preventing erysipelas of the ear is played by the strength of the child's immunity. As a rule, it is still weak in babies, so they catch all infectious diseases faster and easier than adults.
Symptoms of erysipelas in children differ little from those in adults. Parents should pay attention to the fact that the child refuses food, games, is naughty. His temperature rises to 40 degrees Celsius and above, vomiting may occur,delirium, loss of consciousness. With such symptoms, you must immediately call an ambulance. Parents should understand that erysipelas in children (especially in infants) is a deadly disease.
Shortly after the appearance of the first symptoms caused by intoxication of the body due to the active activity of streptococci, local signs appear - a rapidly growing erythema that occurs in the lesion. The skin in this place becomes hot, very painful, glossy, sometimes with a bluish tinge. A characteristic sign of erysipelas is that the inflamed area has clear boundaries.
Diagnosis in children is based on visual examination and blood test, which shows the erythrocyte sedimentation rate, leukocytosis, neutrophil shift, neutrophil granularity, eosinophilia.
Since the causes and symptoms of erysipelas are similar, the treatment of this disease in children also follows the same scheme for patients of any age. Only the dosage of the drugs may differ. Babies are prescribed antibiotics "Erythromycin", "Ezithromycin", "Metapiklin", "Penicillin". Most often they are administered by injection, which is a more gentle method for the digestive tract. If you take antibiotics orally, they quickly lead to dysbacteriosis, as they destroy the beneficial microflora of the stomach and intestines.
Also, the course of therapy includes "Rutin", ascorbic acid, vitamins of group B. With bullous erysipelas, corticosteroids are prescribed. Locally, anti-inflammatory ointments are applied to the sore spot.
Otitis externa
If in the wound formed in the ear,not streptococci of group A penetrate, but any other pathogenic microbes, the child may develop otitis externa. Inflammation of the external ear in this case will resemble erysipelas with its symptoms. Children have:
- Temperature increase.
- Weakness.
- No food.
- Partial hearing loss (due to ear canal swelling).
- Chills.
With otitis externa, there is no hyperemia of the auricle, but a boil is often formed in the ear. A striking sign of otitis media is unbearable pain, which is sharp, dagger-like, radiating to the back of the head, jaw and temple. Children do not let the doctor not only examine the auricle, but even touch it.
When the boil in the ear bursts, the pain subsides a little, and purulent exudate flows from the ear canal.
Diagnosis of otitis media includes:
- External examination of the ear.
- Child's hearing test.
- Tympanometry.
- Bacterial culture of discharge from the ear canal (analysis is necessary to determine the pathogen).
- Blood test (general and glucose).
Despite the similarity of symptoms, the methods of treating otitis media and erysipelas have significant differences. With otitis media, the primary task of doctors is to relieve pain. For this purpose, warming compresses, analgesics are prescribed. Preparations ("Ofloxacin", "Neomycin") are instilled into the ear. Often they are replaced with ointments. Turundas with Flucinar, Celestoderm can be placed in a sore ear. Before this, the ear canal is washed with antiseptic preparations.
Sometimessurgical opening of the boil is prescribed. When the exudate expires, the ear canal is washed with a solution of Furacilin, and the affected area is treated with silver nitrate.
Perichondritis
To understand the nature of this disease, you need to say a few words about the structure of the outer ear. In humans, it consists of the auricle and the auditory canal (external). The sink is a kind of sound catcher. It includes the lobe, the tragus (a small bump located on the side of the cheek), and the antitragus (a large curl that affects the shape of the ears). All parts (except the lobe) are cartilage covered with skin. Its inflammation is called perichondritis of the auricle. When making a diagnosis, erysipelas must be differentiated from this disease, since the algorithm for its treatment is somewhat different.
However, the causes of perichondritis and erysipelas are in many ways similar. Both diseases occur when pathogenic microorganisms penetrate the wounds on the skin of the ear, only in the case of perichondritis it is not streptococcus, but other bacteria (most often Pseudomonas aeruginosa). They should get not only under the skin, but also into the cartilage itself.
The symptoms of both diseases also have common features. With perichondritis, the patient has:
- Heat temperature.
- Weakness.
- Nausea.
- Headache.
- Loss of appetite.
These are common symptoms of intoxication with microbial waste products.
Local signs in perichondritis and erysipelasthe outer ear is also somewhat similar. In both diseases, redness, swelling and soreness of the affected areas of the auricle are observed. However, perichondritis never spreads to the earlobe, face, neck, and other areas of the body where there is no cartilage. Also, with this ailment, fluctuation (accumulation of pus between the cartilage and the perichondrium) can be observed.
Diagnose perichondritis by taking anamnesis, examination, palpation, diaphanoscopy.
The following medications are prescribed for treatment:
- Antibiotics with a wide spectrum of action. Drugs of choice: Tetracycline, Ampicillin, Erythromycin, Ciprofloxacin, Amikacin, Cephalosporin and others.
- Non-steroidal anti-inflammatory "Diclofenac", "Ibuprofen" (they are prescribed for intense pain).
- Compresses. They are made on the basis of alcohol, boric acid, Burov's liquid.
- Local therapy with ointments. Use "Flutsinar", Vishnevsky's liniment, "Lorinden". You can lubricate the inflamed areas with iodine.
- Physiotherapy (UHF, microwave, UV).
Forecasts
With timely treatment, erysipelas of the ear in adult patients is completely cured. If the patient does not comply with the course of therapy, the primary erysipelas passes into a recurrent form, which is much more difficult to cure. Relapses can occur not only in the ear, but also in other parts of the body.
If they occur frequently, symptoms are more mild:
- Temperature up to 38.5 degrees.
- Erythema without edema.
- Less clear boundary between inflamed andhe althy patches.
- Intoxication is mild.
Some diseases contribute to the occurrence of relapses (diabetes mellitus, lymphostasis, venous insufficiency), old age, hypothermia, high physical activity.
Erysipelas of the ear can cause complications: ulcer, abscess, necrosis, sometimes sepsis.
For babies, the prognosis of erysipelas is less rosy. Among this category of patients, a fatal outcome is often observed if treatment is provided late or drugs are prescribed incorrectly.
Without treatment, the disease progresses, spreading to neighboring areas. Sepsis may occur.
Perichondritis of the auricle can be completely cured if the doctor's prescriptions are observed. Without treatment, the cartilage is destroyed, the auricle is deformed.
Otitis externa also responds well to treatment if the patient completes the prescribed course of therapy. Only in rare cases does it become chronic.
Prevention
Prevention measures for all three diseases are the same. They are as follows:
- Keeping the hygiene of the auricle and ear canal.
- Avoiding frostbite, burns, ear bumps.
- Performing all manipulations (for example, piercing the earlobe) only with a sterile instrument.
- Ear hygiene only with items intended for this purpose.
- Increase and strengthen immunity in all available ways.
- Avoiding close contact with people who have infectious diseases.
Parents should watch what they playchildren. They must not be allowed to fall into their hands with objects with which they can injure themselves.
