Few red spots appear on the body. People rush to seek medical help if these spots quickly increase in size, provoke an increase in temperature, cause severe pain and other negative symptoms. That is how erysipelas of the auricle are manifested , and among the people just an erysipelas. This name of the disease has nothing to do with the slang usage of the word “face”. It is taken from the Polish language, which means red rose. Is redness of the auricle dangerous for humans? What causes it? Do I need to treat erysipelas on my ear? All features of the disease are described in this article.
Pathogen
Ears can turn red for various reasons. This is not always a disease. Even in cases when our hearing organs suddenly start to burn and itch, this may not be related to the disease. However, the symptoms of erysipelatous inflammation of the outer ear are so characteristic that when they occur, you should not hesitate to consult a doctor. Erysipelas is a very serious infectious disease caused by streptococci. Many varieties of these bacteria are known. All of them are pathogenic. However, some do not pose a great threat to human health and life, do not even require specific treatment.
Erysipelas of the ear and other parts of the body provoke a group of streptococci related to microbes of the beta-hemolytic type, that is, those that completely destroy red blood cells. There are 20 groups of beta hemolytic streptococci. Representatives of group A cause the erysipelas, considered to be the most dangerous for a person. They are the causative agents of scarlet fever, tonsillitis, bronchitis, rheumatism, pericarditis and myocarditis, pharyngitis, pneumonia, fasciitis. People who have these ailments are sources of the spread of microbes that can be transmitted by airborne droplets, domestic, transplacental and alimentary routes.
In addition, beta-hemolytic group A streptococci are 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 a disease when any injuries appear on the skin.
A feature of these microbes is their low resistance to environmental factors. This means that they die quickly when sanitizing medical instruments and observing personal hygiene rules.
Causes of the disease
Before considering the symptoms and treatment of erysipelas, we will familiarize ourselves with the causes of this disease. It can be primary and recurrent.
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 ones. They can occur in such situations:
- Ear piercing.
- Scratch (e.g. with a fingernail).
- Comb (often observed with eczema, an insect bite).
- Squeezing a pimple.
- Hit.
- Frostbite or burn.
- Cleansing the auricle with objects that are not intended for this.
However, violations of the integrity of the skin do not always lead to erysipelas of the ear. For this to happen, bacteria must get into the wounds. They are transmitted in the following ways:
- From a person who has any of the diseases caused by beta-hemolytic streptococci of group A. Most often it is tonsillitis, bronchitis, pharyngitis. They fall from a patient to a healthy microbe by airborne droplets.
- Through household items shared by the sick and healthy.
- A person who has, for example, a sore throat, can bring an infection into his ear with his own hands if streptococci got on them from the oral cavity.
- When using non-sterile instruments during any manipulations (surgery, piercing).
These are the most likely transmission routes for streptococci. In rare cases, the infection spreads through the hematogenous or lymphogenous pathways.
The primary occurrence of erysipelas of the ear depends largely on the strength of human immunity. Those whose body is weakened by diseases, operations, malnutrition, stress, hard physical work, are highly likely to get erysipelas, as their immunity is not able to withstand bacteria.
Streptococcal inflammation can initially begin at the site of the auricle, and then spread to the face and skin under the scalp. But another course of development is also possible, when initially inflammation occurs on the face, neck, on the head under the hair, and then passes to the ear.
Classification
Erysipelas of the ear can be:
- Primary.
- Repeated.
- Recurrent.
The severity of the course distinguishes such its degrees:
By the nature of localized manifestations, the following forms of erysipelas are distinguished:
- Erythematous. Erythema is formed, that is, redness and swelling of the skin.
- Erythematous hemorrhagic. Hemorrhages occur at the site of erythema due to damage to blood vessels.
- Erythematous bullous. Bubbles filled with exudate appear.
- Bullous hemorrhagic. In this form, the bubbles are filled not with transparent, but with bloody exudate.
Symptomatology
It is difficult not to immediately recognize the symptoms of erysipelas. The treatment of the disease should be professional and comprehensive. This is the only way to completely get rid of the disease. Otherwise, recurring forms of erysipelas are formed. The symptomatology of relapses is about the same as the primary disease. The incubation period can last from a couple of hours to five days. The bulk of patients can name not only the day the disease started, but also the hour, because its first symptoms are extremely acute:
- Heat.
- Chills, fever.
- Unbearable headache.
- Nausea.
- Dizziness.
- Weakness.
- Sometimes there may be a loss of consciousness, delirium.
- Some people experience unpleasant sensations in the ear, but the patients cannot yet accurately describe them. It seems to one that water has got into the ear, to the other that it is as if something is bursting there.
- Myalgic syndrome.
Usually, after 10-20 hours from 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. It:
- Itching
- Redness.
- An increase in temperature in the inflamed area.
- Soreness (cannot be touched).
- Often the skin in this place begins to gloss.
- Edema.
- With a bullous form, blisters with a clear liquid inside appear on the affected areas. Later, erosion and trophic ulcers form in their place.
All patients with erysipelas of the ear are diagnosed with lymphadenitis and lymphangitis (inflammation of the lymphatic vessels and nodes).
In addition, patients may experience tachycardia, arterial hypotension, and cardiac sounds become muffled.
Diagnostics
If the patient seeks medical help before local symptoms appear, the doctor must differentiate erysipelas from the outer ear from other diseases that have similar symptoms. If the patient's condition is serious (he has a high fever, vomiting, dizziness, delirium), he will be 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. Blood is also taken from the patient for a general analysis in order to make a picture of the condition of white blood cells, platelets and red blood cells.
If, when going to the hospital, the patient already has signs of inflammation of the auricle, it is necessary to differentiate the erysipelas from other skin diseases, such as phlegmon, abscess, erisipeloid, eczema, dermatitis, otitis media and others.
Great help in the diagnosis is provided by 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 the finger on the hyperemic area, the redness disappears. In addition, any touch to a problem place causes severe pain. This is one of the differences between erysipelas and eczema, in which such sensitivity is not observed.
Then, using special tools, the doctor performs an otoscopy of the ear canal in order to assess its condition.
An important sign of erysipelas is that with this disease there is a clear boundary between the affected area and healthy (there is no gradual transition, blurred borders).
If there are discharge from the ear, their samples are taken for examination.
Treatments for erysipelas of the ear
Therapy of this disease necessarily includes a course of antibiotics. Hemolytic streptococci are highly sensitive to sulfamylamides, penicillin preparations, nitrofurans, which facilitates the task of doctors. The course may be like this:
- Drugs of choice: Erythromycin, Clindamycin, Oleandomycin, Ampicillin trihydrate. Patients are prescribed these funds orally or intramuscularly. Treatment is carried out for 5-7 days.
- Effectively operate drugs of different groups prescribed by one course, for example, "Phenoxymethylpenicillin" and "Furazolidone."
- "Biseptolum" (reception of 7-10 days).
- Antihistamines.
- Vitamins
- Nonsteroidal anti-inflammatory.
- In severe cases of the disease, biostimulants are prescribed (Levamisole, Methyluracil).
- In special cases, placental gamma globulin is introduced into the course, a transfusion of plasma and blood is done.
They 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), a significant improvement occurs. In a patient, the temperature decreases to normal, hyperemia of the auricle decreases, and the general condition improves.
Erysipelas 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 at the sites of damage to the skin of the auricle. The child must carry out hygiene procedures of the ears.
Parents should remember that the baby’s hearing organs are very tender, 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, with cotton buds 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 when bathing in the ears of children did not get water.
Kids, through negligence, can injure themselves in the ear with any object (twig, pencil, pen).
In some cases, the skin can be injured by a hearing aid.
An important role in preventing erysipelas is played by the strength of the child’s immunity. As a rule, in children it is still weak, so they are faster and easier than adults to catch all infectious diseases.
Symptoms of erysipelatous ear inflammation in children differs little from that 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, delirium, and loss of consciousness may be observed. With such symptoms, you must immediately call an ambulance. Parents should understand that erysipelas in children (especially in infants) is a deadly ailment.
Soon after the onset 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 tint. A characteristic sign of erysipelas - the inflamed area has clear boundaries.
Diagnosis in children is carried out on the basis of a visual examination and blood test, which shows the erythrocyte sedimentation rate, leukocytosis, neutrophilic shift, neutrophil granularity, eosinophilia.
Since the causes and symptoms of erysipelas of the ear are similar, the treatment of this disease in children also takes place according to a single scheme for patients of any age. Only the dosage of the drugs can differ. Babies are prescribed antibiotics "Erythromycin", "Ezithromycin", "Metapiclin", "Penicillin." Most often they are injected, which is a more gentle method for the digestive tract. If you take antibiotics orally, they quickly lead to dysbiosis, as they destroy the beneficial microflora of the stomach and intestines.
Also, Rutin, ascorbic acid, and B vitamins are included in the course of therapy. With bullous erysipelas, corticosteroids are attributed. Locally, anti-inflammatory ointments are applied to the sore spot.
Otitis externa
If not a group A streptococcus, but any other pathogenic microbes penetrate into the wound formed in the ear region, but an external otitis media may begin in the child. Inflammation of the outer ear in this case will resemble the face with its symptoms. In children, there are:
- Temperature rise.
- Weakness.
- Refusal of food.
- Partial hearing loss (due to swelling of the ear canal).
- Chills.
With external otitis media, there is no hyperemia of the auricle, however, boils very often form in the ear. A striking sign of otitis media is unbearable pain, which can be sharp, dagger, giving to the back of the head, to the 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.
- Checking a child’s hearing.
- Tympanometry.
- Back sowing of secretions 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. Drugs (Ofloxacin, Neomycin) are instilled into the ear. Often they are replaced with ointments. Turunds with "Flucinar", "Celestoderm") may be placed in a sore ear. Before this, the auditory meatus is washed with antiseptic drugs.
Sometimes a surgical opening of the boil is prescribed. At the end of the exudate, 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 ear canal (external). A sink is a peculiar catcher of sounds. It includes the lobe, the tragus (a small tubercle located on the side of the cheek) and the anti-tragus (a large curl affecting the shape of the ears). All parts (except the lobe) are cartilage covered in skin. Its inflammation is called perichondritis of the auricle. Erysipelas during diagnosis must be differentiated from this disease, since the algorithm for its treatment is somewhat different.
However, the causes of perichondritis and erysipelas are very similar. Both diseases occur when pathogenic microorganisms penetrate into 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 fall not only under the skin, but also in the cartilage itself.
Symptoms of both diseases also have common features. With perichondritis, the patient has:
- Heat.
- Weakness.
- Nausea.
- Headache.
- Loss of appetite.
These are common symptoms that occur during intoxication with the waste products of microbes.
Local signs with perichondritis and erysipelas of the outer ear are 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 parts of the body where there is no cartilage. Also, with this ailment, fluctuation (accumulation of pus between the cartilage and perichondrium) can be observed.
Diagnose perichondritis by collecting anamnesis, examination, palpation, diaphanoscopy.
For treatment, the following medications are prescribed:
- 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 liquid.
- Local ointment therapy. Use "Flutsinar", liniment Vishnevsky, "Lorinden." You can lubricate the inflamed areas with iodine.
- Physiotherapy (UHF, microwave, ultraviolet radiation).
Forecasts
With the timely treatment of erysipelas in adult patients, it is completely cured. If the patient does not follow the course of therapy, the primary erysipelas passes into a relapsing 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, the symptoms are more moderate:
- Temperature up to 38.5 degrees.
- Erythema without edema.
- Less clear border between the inflamed and healthy sites.
- Intoxication is weak.
Some diseases (diabetes mellitus, lymphostasis, venous insufficiency), old age, hypothermia, high physical exertion contribute to relapse.
Erysipelas of the ear can cause complications: ulcers, abscesses, necrosis, sometimes sepsis.
For babies, erysipelas have less optimistic predictions. Among this category of patients, a fatal outcome is often observed if treatment is delayed 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 prescribes. Without treatment, the cartilage is destroyed, the auricle is deformed.
External otitis media is also well treatable if the patient completely undergoes 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:
- Hygiene of the auricle and ear canal.
- Avoidance of frostbite, burns, blows to ears.
- Performing all manipulations (for example, piercing the lobe) only with a sterile instrument.
- Carrying out hygiene of the ears only with objects intended for this purpose.
- Enhancing and strengthening immunity in all available ways.
- Avoid close contact with people who have infectious diseases.
Parents should keep track of what their children are playing. They must not be allowed to fall into their hands with objects that they could cause personal injury.