Erysipelas ( erysipelas ) - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

Erysipelas (erysipelas) - a disease that is caused by a microorganism - streptococcus and is characterized by local inflammation of the skin and mucous membranes, fever and symptoms of intoxication.

Greek name "erysipelas" disease, which literally translates as red skin.This definition accurately describes the appearance of the skin in the acute stage of the disease.The name "mug" - native Russian.It is believed that it is related to the change of facial features due to swelling and redness at the height of the disease.

Erysipelas - a widespread infectious disease with a low degree of infectiousness.The disease is found everywhere, are diagnosed annually 15-20 cases per 10,000 population.Up to 70% of all cases occur in the summer and autumn months.

Causes of erysipelas

face of particular micro-organism - the beta-hemolytic streptococcus group A. In uncomplicated course of the disease, he plays a major role.Under conditions of reduced immunity to streptococcal inflammation can join and representativ

es of other flora, particularly Staphylococcus aureus.Then, the disease is more difficult due to the development of septic complications, less treatable.

Beta-hemolytic streptococcus has a high resistance to environmental factors.It remains viable for a long time in drying, freezing, the temperature is raised to 560 ° C only killed 30 minutes later.At the same time the standard disinfecting solutions completely destroy the pathogen.

The factors that contribute to the infection of erysipelas include:

• existing diseases associated with damage to the integrity of the skin and impaired skin nourishment: a fungal skin lesions, diabetes, obesity, chronic venous insufficiency;

• constant trauma of the skin in the performance of professional duties, work related to the permanent contamination of the skin (the miners), long wearing rubber shoes and so on. Etc .;

• decreased immunity after the disease, hypothermia, vitamin deficiencies;

• availability of sources of chronic infection (tonsillitis, dental caries, otitis media, and others.).

The source of infection is a sick person with signs of erysipelas or carrier.The carrier is called the patient, the body is constantly present streptococcus without the appearance of characteristic symptoms of erysipelas.

With dirty hands, clothing, footwear, as well as non-compliance with the rules of sterilization dressings and medical instruments streptococcus ingested.need for penetration of the microorganism so-called "gate of infection."This may be an abrasion, abrasion, crack, biting insects, particularly if they are combed, and sometimes even invisible to the eye microscopic skin damage.Erysipelas is formed only in people with reduced immunity.The rest of the people's own defense system of the body to cope with micro-organisms, and the disease does not occur.Therefore, the most commonly diagnosed erysipelas in the elderly, women during pregnancy and the postpartum period, as well as in patients with long-standing chronic diseases.

After penetrating the skin pathogen begins the process of intensive growth of microorganisms.At the same time, a large amount of toxins that are getting into the bloodstream, causing fever, chills and other symptoms of intoxication.Further Streptococcus settles in the lymph nodes, where it is destroyed by natural protective factors or organism under the action of antimicrobial therapy.In people with lowered immunity may not be complete pathogen destruction, which leads to a return of the disease after a while.

Immunity after recovery does not develop.On the contrary, due to hypersensitivity to streptococci in patients after myocardial erysipelas more frequently develop recurrent disease.

Symptoms of erysipelas

from infection to onset of symptoms of erysipelas takes several hours, at least 2-3 days.Typically, the disease begins abruptly with fever up to 39-40 ° C, headache, muscle pain, weakness, nausea, vomiting, in some cases at the time of temperature rise.Very quickly, swollen lymph nodes, especially the most closely located to the affected area.

The skin in the affected area at the beginning of the disease there is an itch, a burning sensation.Approximately during the day in this place develops pain, heat, redness, which is just a few hours significantly increases in size.Classic erysipelas is a skin is bright red with clear boundaries, irregular edges in the form of "flames", several towers over the surface of healthy skin.

Erysipelas right lower extremity.The characteristic appearance of the affected areas: skin red, with sharp edges, jagged edges in the form of "flames".

When the feeling skin in this area is hot, painful.On the skin, the formation of bubbles with transparent, bloody or purulent contents.

Erysipelas of the left lower limb, bullous form.Visible bubbles, detachment of the upper layers of the skin to form a moist surfaces.

often in the form of redness bleeding like small bruises.

Erysipelas in the right shoulder and arm, hemorrhagic form.Visible small petechial hemorrhages.

inflammation occurs most often around the nose, cheeks butterfly, at the corners of the mouth, in the area of ​​the external auditory meatus.

Erysipelas face.Noteworthy pronounced swelling in the affected area.

Less pathological process is formed in the area of ​​hair growth on the head, on the skin of the lower extremities.The minimum percentage of cases diagnosed erysipelas in other areas.Erysipelas in the face area is characterized by marked swelling and tenderness.

Increased body temperature is maintained during the treatment up to 10 days.Cutaneous manifestations are held a little longer - up to 15 days.Recurrence of the disease may occur in the period up to 2 years after recovery.Generally, when returning the patient's disease state of health is not impaired, the disease is diagnosed when a skin pale red spots, edema, usually not expressed.

Diagnostics erysipelas

Laboratory Methods do not have an independent value in the face, and the diagnosis "erysipelas", in most cases, is placed upon detection of the characteristic clinical signs of disease:

• sudden onset of illness with fever, pronounced symptoms of intoxication.

• skin lesions of the face and lower extremities.

• typical manifestations of erysipelas on the skin.

• swollen lymph nodes.

• alone in the absence of pain in the affected area.

Treatment of erysipelas

Patients with erysipelas, despite the leading role of infection in causing the disease usually do not pose a danger to others.Therefore hospitalization in infectious department only recommended in severe disease with severe manifestations of intoxication, with significant distribution of inflammation, with frequent relapses, as well as in any case, the development of the disease in children and the elderly.

When the body temperature increased fluid intake is recommended.Antipyretic drugs (aspirin) shows only the temperature increases to 39 ° C and above.During fever, as well as in the development of lower limb erysipelas skin inflammation in all patients required bed rest.

faces Drug therapy includes the following components:

• Antibacterials.For home treatment prescribers in tablet form.Preference is given to such drugs as erythromycin, doxycycline, azithromycin, ciprofloxacin.At the hospital, intramuscularly administered drugs are penicillins and cephalosporins.antibiotic treatment course is 7-10 days.After that, when improving the condition of the patient is considered to be non-contagious to others, and can be discharged.

• Anti-inflammatory drugs are recommended in patients with severe swelling and tenderness of the skin of the affected area.The most common drugs such as phenylbutazone, hlotazol, who are appointed for 10-15 days.At the expressed symptoms of intoxication shown intravenous drip solutions (gemodez, isotonic sodium chloride solution, glucose solution) in combination with diuretics and anti-inflammatory drugs.

• Local treatment of erysipelas is only necessary in case of bubbles in the area of ​​inflammation.Otherwise, application of ointments and compresses is not only useless but harmful.In the presence of intact their bubbles gently opened, and after the contents of the output used bandages or with rivanol furatsilinom.Change dressings performed several times a day.When local hemorrhages recommended applications with BHT.From

• physiotherapeutic treatment in the acute stage it can be recommended ultraviolet radiation to the affected region, and on the area of ​​the lymph nodes.For a speedy recovery appointed ozokerite, Naftalan ointment, paraffin baths, electrophoresis lidazy, calcium chloride.

Erysipelas - a disease with a proven development mechanism, which, if delayed treatment can lead to patient deaths. Therefore, the use of folk methods of treatment, as well as plots with already developed skin lesions is contraindicated.

After this illness patients are under the supervision of an infectious disease clinic for three months, after erysipelas recurrence within two years.

Possible complications of erysipelas

Complications faces usually occur in the affected area, and are found in 5-8% of cases.Upon accession, the concomitant infections develop abscesses, cellulitis, thrombophlebitis veins, lymphangitis (inflammation of the lymphatic vessels).Treatment of these complications is made in the department of purulent surgery.Systemic complications of erysipelas develops extremely rarely, only in patients with a significant reduction of the protective properties of the organism.Such conditions include sepsis, toxic shock, pulmonary embolism, and others. In this case, the patient is hospitalized in the intensive care unit.

prognosis of erysipelas

With timely treatment of a full recovery is possible.In some cases, relapse of the disease.

Prevention erysipelas

General preventive measures are in compliance with the rules of personal hygiene, treatment of skin diseases.If you violate the integrity of the skin it is recommended timely disinfection and the imposition of an insulating bandage.

If recurrent inflammation prophylactically administered intramuscularly antimicrobial bitsillin.Dose and frequency of administration is calculated individually for each patient depending on the frequency and degree of severity of relapses.

therapists Sirotkin EV