Erysipelas

Introduction

Erysipelas is an acute superficial spreading infection commonly caused by Streptococci without pus formation.
It could also be due to Gram negative bacilli.

Symptoms and clinical presentation of erysipelas

A prodrome of fever, chills, and malaise

  • Locally, a large erythematous, swelling, well-demarcated, and usually raised lesion
  • Regional adenopathy is frequent
  • Superficial blistering secondary to edema,
  • Superficial hemorrhage, may be sometimes be observed.

Treatment for Erysipelas

Non-pharmacological Treatment

  1. Bed rest
  2. Elevation of the affected part
  3. Venous compression is recommended during the acute phase and subsequent weeks to reduce the risk of lymphedema
  4. Prophylaxis of deep venous thrombosis (DVT) should be considered depending on presence of other risk factors

Pharmacological Treatment

Weak potassium permanganate soaks.
1:40000 (0.025%) solution, 12hourly for 3 to 4 days, with each session lasting for 15-20minutes

AND

Silver sulfadiazine cream (topical), 12 to 24 hourly

OR

Mupirocin (topical) 2% 12 hourly for 5-7days

OR

Fusidic Acid (topical) 2% 12 hourly for 5-7days

AND

Phenoxymethylpenicillin (PO):

  • Adult 250-500mg:
  • Child: 25mg/kg 6hourly for 5 to 7days

OR

Flucloxacillin amoxicillin (FDC) (PO):

  • Adult 500mg:
  • Child: 25-50/kg 6hourly 5 to 7 days

AND

Ibuprofen 400mg (PO) 6hourly for 5days

Referral criterion

Refer if there are local or general signs severity of developing necrotizing fasciitis.