What’s Erysipelas?

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Erysipelas is a rare form of bacterial infection that mainly affects the face or legs. It is a variant of cellulitis (skin infection). However, where cellulitis can occur anywhere on the body and can be caused by different bacteria, erysipelas is usually only caused by the bacterium streptococcus pyogenes and occurs only in the locations mentioned above.

One form of erysipelas, called porcine erysipelas, was a persistent problem for pig farmers before the invention of antibiotics. Pigs would regularly die and entire herds could suffer from the disease. What started out as lesions, in this case, all over the body, would quickly progress to organ damage and eventually cause death. Now pigs are routinely inoculated for the disease in the form of preventive doses of antibiotics to avoid contracting the disease.

Erysipelas in humans is still rare. However, it requires immediate treatment. If left untreated, it can damage your heart and joints. If you look into the lives of interesting people from the past or in family histories, you see the deaths of many from erysipelas. Anyone who lived before the development of antibiotics would see the disease progress and particularly in the joints where it would cause a lot of pain. Many in the Victorian era became addicted to opium in an attempt to deal with the pain of the condition.

Today, erysipelas is almost always recognized. The rash on the face may follow a butterfly pattern, spreading to the nose and cheeks. Symptoms begin quickly and the rash is raised and orange or purple from small blood vessels that bleed into the skin. The pronounced swelling and color of the rash make it difficult to confuse erysipelas with other forms of cellulitis.

The rash is painful and may be accompanied by chills and fever. Such a rash means seeing a doctor as soon as possible to start treatment. Treatment in the early stages usually means a 2-week course of oral penicillin or a penicillin-derived antibiotic. If you are allergic to penicillin, you may use some of the newer antibiotics instead.

Erysipelas can spread rapidly, particularly to the joints. When the rash on the face or legs goes untreated, those with the infection may require lifelong daily doses of antibiotics to minimize joint infection. Usually, however, the signs of infection are so severe and painful that people will seek early treatment.
Anyone can get erysipelas, but it seems to be more predominant among the very young and the elderly. There are several predisposing factors for contracting erysipelas. Very often bacteria enters a recent surgical wound and such swelling around the wound usually indicates at least one form of cellulitis. Insect bites, cuts, and pimples can expose one to the causative bacteria. On the face this bacterium is commonly found in the nose and is responsible for most of the erysipelas found on the face.

Some populations are more likely to get erysipelas. Anyone with an autoimmune disease such as lupus or HIV is more at risk. Those who have poor blood perfusion through blocked veins, impaired heart function, or heart defects are also more likely to become infected. Those living in persistently unsanitary conditions, such as the homeless, seem more prone to contracting erysipelas. Additionally, alcoholism is a risk factor for getting erysipelas and a host of other infections.

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