What is a erysipelas?
Erysipelas – an infectious disease with the general intoxication of the organism and the inflammatory skin lesions. Pathogen – erysipelatous streptococcus, is stable outside the human body is very tolerant of desiccation and low temperature, dies when heated to 56 degrees Celsius for 30 minutes. The source of the disease is the patient and carrier. Contagious (contagious) is insignificant. The disease is recorded as separate cases. Infection occurs mainly in violation of the integrity of the skin with contaminated objects, tools or hands.
By the nature of lesions are distinguished:
1. erythematous form in the form of redness and swelling of the skin;
2. hemorrhagic form with the phenomena of permeability of blood vessels and bleeding;
3. bullous form of blisters on inflamed skin filled with serous fluid.
Bacterial Erysipelas
By the degree of intoxication emit – light, moderate, severe. On multiplicity – primary, recurrent, re.
As the prevalence of local manifestations – localized (nose, face, head, back, and so on.) Wandering (moving from one place to another), and metastatic.
Symptoms (signs) of erysipelas.
The incubation period of 3 to 5 days. Acute onset, sudden. In the first day more pronounced symptoms of intoxication (severe headache, chills, general weakness, possible nausea, vomiting, fever up to 39-40 degrees Celsius).
Erythematous form. After 6-12 hours of onset, there is a burning sensation, pain Expander nature of the skin – redness (erythema) and swelling at the site of inflammation. Struck erysipelas plot clearly separated from the healthy sublime sharply painful roller. The skin in the source area hot to the touch, tense. If there Punctulata hemorrhage, then talk about erythematous-hemorrhagic form of erysipelas. When bullosa erysipelas on the background of erythema at different periods after its occurrence bullous form elements – the bubbles contain a light and transparent liquid. Later, they fall off, forming a thick brown crust, rejected in 2-3 weeks. In place of bubbles can be formed and the erosion of trophic ulcers. All forms of faces accompanied the defeat of the lymphatic system – lymphadenitis, limfangitom.
Primary erysipelas often localized on the face, recurrent – in the lower extremities. There are early relapses (up to 6 months) and late (over 6 months). Contribute to the development of their associated diseases. The most important are chronic inflammatory foci of the disease lymphatic and blood vessels of the lower extremities (phlebitis, thrombophlebitis, varicose veins), diseases with a pronounced component of allergic diseases (bronchial asthma, allergic rhinitis), skin diseases (mycoses, peripheral ulcers). Relapses occur and as a result of adverse occupational factors.
Duration of the disease, the local manifestations of erythematous erysipelas are to 5.8 day of illness, in other forms may hold more than 10-14 days. Vestiges faces – pigmentation, peeling, pastoznost skin, the presence of dry dense crusts on the site of bullous elements. Perhaps lymphostasis development, leading to elephantiasis of the limbs.
Treatment of erysipelas
Depends on the form of the disease, its multiplicity, the degree of intoxication, presence of complications. Etiotropic therapy: antibiotics, penicillin in the number of average daily dose (penicillin, tetracycline, erythromycin, or oleandomitsin, oletetrin, Capoten, Hytrin, Lopid, Mevacor). Less effective drugs sulfonamides, combined chemotherapy (Bactrim, septin, Biseptol). Course of treatment is usually 8-10 days. With frequent recurrences of persistent recommend tseporin, oxacillin, and methicillin ampitsillip. It is desirable to conduct two courses of antibiotics with the change agents (the intervals between courses of 7-10 days). If often recurrent erysipelas use corticosteroids in a daily dosage of 30 mg. With persistent infiltration of displaying non-steroidal anti-inflammatory drugs – hlotazol, butadion, reopirin, etc. It is advisable the appointment of ascorbic acid, rutin, vitamin B supplements give good results autohaemotherapy. (more…)
