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, the inflammatory process develops. Immunity after the transferred disease is not formed, therefore, relapses are frequent. Which doctor treats erysipelas? This question worries those who are faced with this problem.
If the first signs of the disease are detected, you should contact the local doctor, who, if necessary, will be referred to a surgeon or infectious disease specialist. There are quite a few complications of the disease (abscess, thrombophlebitis, elephantiasis, necrotic, phlegmonous, erythematous erysipelas) and some of them are life-threatening for the individual.
Historical information
Erysipelas 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. In the second half of the nineteenth century, cases of an outbreak of erysipelas in maternity hospitals and hospitals of a surgical profile were described. At that time, it was believed that this pathology was highly contact. The first pure culture of streptococcus was obtained by the scientist Feleisen I. in 1882 from a patient with erysipelas. Further study of the pathogenetic mechanisms and epidemiological features, as well as the effect of the therapy with sulfonamides and antibiotics, changed the idea of this disease. In Soviet times, erysipelas was also actively studied.
The main factors in the development of erysipelas
Causes of erysipelas:
- constant contact with contaminants 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 products, insect bites, in newborns, navel wounds;
- lymphostasis
- the presence of chronic pathologies: otitis media, diabetes mellitus, tonsillitis in the chronic stage;
- reduced immunity.
The clinical picture of erysipelas
The incubation period of erysipelas (ICD-10: A46) is short, the inflammation develops rapidly.
At the initial stage, the following symptoms appear:
- body temperature rises to 39 degrees, which lasts up to ten days;
- chills, weakness;
- breaks joints and bones;
- possible cramps;
- blurred consciousness (rarely);
- bouts of nausea or vomiting.
On the first day of the disease, places where there are wounds and scars swell, redden, a burning sensation and pain appear. Lymph nodes located next to the affected area increase and become painful. The formation of blisters and hemorrhages in the wound area is possible.
Further, the disease progresses, the symptoms increase. Apathy develops, sleep is disturbed. The affected area becomes hot, painful, swollen, dense to the touch with clear curved borders resembling tongues of flame. Lymph nodes are painful, dense and restrict mobility. From the lesion to the lymph nodes appears a strip of pale pink staining. Possible increased pressure, tachycardia. After a few days (about seven), the temperature decreases, the affected focus becomes paler, swelling decreases, the size of the lymph nodes decreases, there is peeling of the dermis.
Is an erysipelas contagious or not? It is contagious to others throughout the entire period of therapy.
Different locations of erysipelas
Erysipelas of the face. It develops both in the primary and in the secondary episode of the disease.
With simultaneous damage to the forehead, cheeks and nose, significant visible changes are observed, the face is distorted. Swelling of the eyelids with inflammation leads to a narrowing of the palpebral fissures. In some cases, the patient cannot open his eyes. The submandibular lymph nodes enlarge and become painful.
Erysipelas of the scalp. Severe pain in the area of inflammation is noted. Infiltration is present, redness is rare.
Erysipelas of the upper limbs. It is rarely diagnosed. Postoperative lymphostasis of the hand 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, the labia majora in women. Erythema is localized on the abdomen and pubic region, rarely on the hips and buttocks.
Erysipelas of the mucous membranes. It is rare. The most dangerous 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. It develops during menstruation. During menopause, regular relapses are noted.
- Recurrent. It is common. The localization of inflammation is observed at the site of the primary lesion. Remission lasts from a few weeks to two years. Improper treatment, chronic derma diseases (mycoses), the presence of streptococcal infection in the body, frequent hypothermia, microtraumas contribute to the development of chronic recurrent erysipelas.
- Re. Diagnosed two years after primary with a different localization.
- Erysipelas Vikhrova or “gelatinous” recurrent. It develops against the background of elephantiasis. Erythema is mild, there is no clear line between healthy and affected dermis.
- White face of Rosenberg-Unna. It is detected in patients with leprosy, tuberculosis, syphilis and other diseases. It manifests itself as 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, you should begin treatment for this disease. 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 drugs:
- antipyretic;
- antihistamines;
- sulfonamides, and in case of intolerance to antibiotics, these are the drugs of choice;
- immunostimulants.
For compresses apply:
- "Furacilin."
- "Dimexide."
- Enteroseptol.
They are made until the wound surface is completely healed every day.
Recommended ointments for erysipelas:
- Levomekol. Use as an independent tool.
- Naftalan. It is used together with physiotherapeutic treatment.
Timely and correctly selected therapy leads to a complete recovery. The lifestyle in this disease does not differ from the usual. For preventive purposes, it is recommended to keep the skin clean. When 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. The most popular remedy is kombucha.
Moisten a piece of gauze with a well-infused and filtered solution and wipe the affected area. Using medicinal plant materials, such as coltsfoot, you can make a compress. Impose 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, it must be remembered that the use of the above methods gives a good effect only in combination with traditional therapy.
Preventive action
These include:
- personal hygiene;
- treatment of damaged areas of the dermis with antiseptic agents;
- timely treatment of fungal infections of the feet, nails;
- maintaining immunity;
- wearing loose clothing made of cotton materials;
- health promotion;
- patients with diabetes mellitus, follow all the recommendations of a doctor;
Important: the prerequisite for the formation of a dangerous form of the disease, namely gangrenous erysipelas, is diabetes.
If relapses occur, doctors recommend antibacterial agents to prevent secondary infections. For these purposes, usually prescribed drug "Bicillin." 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 causative agent of the disease.
Erysipelas in a child
According to statistics, boys suffer from this infectious skin disease less often than girls. The disease is characterized by seasonality, and infection occurs mainly in the autumn-summer period. Some kind of selective predisposition or even susceptibility to this streptococcal infection affecting soft tissues is noted. After some illness, some children develop unstable immunity, and they can be sick repeatedly. The transmission of erysipelas or infection with streptococcus occurs:
- through damaged mucous membranes or dermis;
- when using contaminated medical devices or materials for dressing;
- in the presence of a streptococcal focus of infection in the body.
The incubation period lasts from several hours to five days. In children, quite often suffering from this disease, hypothermia and stress are a prerequisite for its development.
Signs of the disease in children
Erysipelas begins acutely, a significant development of intoxication is in its initial stage. These symptoms are ahead of the first signs of the disease from a few hours to a day. During this period, the baby appears:
- general malaise;
- muscle pain
- chills;
- vomiting
- nausea;
- hypothermia;
- in areas of the dermis, where local manifestations of the disease subsequently appear, pain, burning, bursting are observed.
The disease progresses quite quickly. Local reactions appear immediately after the peak of febrile events and intoxication of the body. The most common location for erysipelas is the lower extremities. Initially, a small spot of pink or red color is formed, which after a few hours takes on a specific form. The dermis in the affected area is swollen, hot to the touch, painful on palpation, the existing bubbles are filled with liquid and may burst. In their place are yellowish-brownish traces that pass over time.
Therapy in children
With a mild form of erysipelas and the absence of complications, treatment is carried out on an outpatient basis. Hospitalization is indicated in the following cases:
- small age of the child;
- frequent relapses;
- the presence of serious concomitant pathologies;
- severe course.
Antibiotics are prescribed for treatment . For erysipelas , different groups are used: macrolides, fluoroquinolones, tetracycline series, combined and broad-spectrum drugs. In case of intolerance to antibiotics, ten-day courses of Furazolidone and Delagil are prescribed. In hospital conditions, penicillin group preparations, aminoglycosides and cephalosporins are used. If necessary, detoxification therapy is carried out. Regardless of where the child is treated, for medical reasons prescribed:
- vitamin complexes;
- antipyretic drugs;
- anti-inflammatory drugs;
- diuretics;
- cardiovascular drugs;
- physiotherapeutic treatment.
Preventive actions
In order to prevent the disease of erysipelas in children, parents need to adhere to some recommendations:
- avoid injuries and abrasions of the lower extremities;
- with frequent relapses, carry out prophylaxis with antibacterial drugs that can stop the spread of infection in the children's body;
- if staph infection is detected, treat it in a timely manner.
The duration of the drug is determined by the attending doctor.
Erysipelas in newborns
In babies, this pathology develops very quickly. The navel is initially affected, then the infection spreads throughout the body, capturing the joints and limbs. Intoxication syndrome develops . Erysipelas with a lesion of the nose and ears are quite rare. In these cases, a complication in the form of meningitis almost always develops. Perhaps the development of pathology on the background of diaper rash. With a disease of pregnant erysipelas, the fetus develops septic intrauterine infection.
Erysipelas on the leg
It manifests itself as inflammation of the skin of the lower extremities. Most exposed to it are individuals working in unsanitary conditions, who have been outdoors for a long time. As a result, there is contact with dust and dirt, which contributes to the entry into the body of streptococcal infection.
The place where the pathological process appeared becomes hot and turns red. Untimely started treatment is fraught with serious complications. There are several ways of penetrating staphylococcus, as well as the reasons for the development of this pathology:
- injuries
- burns;
- insect bites;
- combs;
- chronic tonsillitis;
- untreated caries;
- reduced immunity;
- regular hypothermia of the legs;
- stressful situations;
- excess ultraviolet light;
- thrombophlebitis or varicose veins of the lower extremities;
- ulcerative lesions;
- alcoholism.
Causes of the disease
After the incubation period, the initial signs begin to appear:
- general weakness;
- temperature rise;
- severe headaches;
- nausea;
- vomiting
- diarrhea;
- muscles feel pain and fatigue.
Local manifestations appear immediately or in a day.
Forms of the inflammatory process
There are several forms of erysipelas:
- Erythematous. The affected area acquires a reddish even shade, has clear boundaries, the shape of the edges of the spot is irregular.
- 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 having a light brown color forms in its place. 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 can occur in the affected areas.
- Bullous hemorrhagic. Unlike erythematous-bullous blisters, they are filled with blood.
Treatment of erysipelas on the leg
At the first signs of the disease, you should contact your local doctor. Self-medication is strongly discouraged. Treatment for 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. For therapy, the following groups of drugs are prescribed:
- antibacterial;
- sulfonamide;
- anti-inflammatory;
- diuretics;
- vascular;
- vitamins A, B, C;
- angioprotectors.
Of the physiotherapeutic procedures, the most effective for erysipelas on the leg are:
- ultraviolet radiation;
- laser therapy;
- exposure to high frequency current.
Alternative medicine
Folk recipes:
- The leaves of coltsfoot and chamomile flowers, taken in equal parts, mix with honey. The resulting composition to treat the affected area. For allergic reactions to beekeeping products do not use.
- Prepare a mixture of sour cream and chopped burdock leaf. Apply to damaged skin.
- Prepare an infusion of plantain leaves, add honey. The resulting solution to treat the affected area.
- Treating the affected area with pork fat every two hours will help relieve inflammation.
- Pound chalk and sprinkle them with a sore spot of the dermis, apply a compress. The procedure is carried out before bedtime. This method is considered very effective.
Finally
All pathologies caused by streptococcal infection, if untreated, can lead to serious consequences. Erysipelas in this case is no exception. Complications of the disease: blood poisoning, abscesses, phlegmon, thrombophlebitis, elephantiasis. Thus, only timely, qualified medical assistance will help to successfully cope with this ailment.