1
|
Destoop J, Vanhaecke C, Bani-Sadr F, Plenier Y, Viguier MA, Hentzien M. Significantly reduced duration of antibiotic prescription for erysipelas subsequent to the 2019 French guidelines on skin and soft tissue infection: A before-after study. Infect Dis Now 2024; 54:104887. [PMID: 38492802 DOI: 10.1016/j.idnow.2024.104887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND New skin and soft tissue infections (SSTI) guidelines were published in 2019 in France, changing the recommended duration for antibiotic treatment. The objective of the present study was to assess the impact of the publication of the 2019 French guidelines on SSTIs on the duration of antibiotic prescription for erysipelas. METHODS In a before-after study (a year before and a year after April 1st, 2019), we included all adult patients diagnosed with erysipelas in Reims University Hospital medical wards and the emergency department. We retrospectively retrieved antibiotic prescription duration in the patients' medical files. RESULTS Among 50 patients in the "before" and 39 in the "after" group, the mean duration of antibiotic prescription was significantly shorter in the "after" group (9.4 ± 2.8 vs. 12.4 ± 3.8 days, p = 0.0001). CONCLUSIONS A 25% decrease in the duration of antibiotic prescription for erysipelas was observed following the implementation of these guidelines, providing useful information for an antibiotic stewardship policy.
Collapse
Affiliation(s)
- Justin Destoop
- Department of Dermatology, Robert Debré University Hospital, Avenue du general Koenig, 51092 Reims Cedex, France.
| | - Clélia Vanhaecke
- Department of Dermatology, Robert Debré University Hospital, Avenue du general Koenig, 51092 Reims Cedex, France
| | - Firouzé Bani-Sadr
- Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, Robert Debré University Hospital, Avenue du general Koenig, 51092 Reims Cedex, France
| | - Yannick Plenier
- Pediatric Emergency Department, American Memorial Hospital, 47 Rue Cognacq-Jay, 51100 Reims, France
| | - Manuelle-Anne Viguier
- Department of Dermatology, Robert Debré University Hospital, Avenue du general Koenig, 51092 Reims Cedex, France
| | - Maxime Hentzien
- Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, Robert Debré University Hospital, Avenue du general Koenig, 51092 Reims Cedex, France; University of Reims Champagne-Ardenne, Reims, France
| |
Collapse
|
2
|
Gambichler T, Schubert L, Abu Rached N, Susok L. Clinical characteristics and complete blood count data of 506 patients with erysipelas: Predictors for length of hospitalization and recurrence. J Eur Acad Dermatol Venereol 2023; 37:e1161-e1163. [PMID: 37150948 DOI: 10.1111/jdv.19169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/26/2023] [Indexed: 05/09/2023]
Affiliation(s)
- Thilo Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - Luzie Schubert
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Nessr Abu Rached
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Laura Susok
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Klinikum Dortmund gGmbH, Dortmund, Germany
| |
Collapse
|
3
|
Łyko M, Kaczmarek M, Nekrasova P, Hryncewicz-Gwóźdź A, Maj J, Jankowska-Konsur A. What factors affect the length of hospitalization in patients with erysipelas? A 10-year retrospective study of patients hospitalized in Lower Silesia, Poland. ADV CLIN EXP MED 2021; 30:981-985. [PMID: 34410045 DOI: 10.17219/acem/136504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Erysipelas is an acute skin infection caused by group A and G streptococci. This infection is associated with many comorbidities and often requires hospitalization. OBJECTIVES The aim of this study was to identify the factors related to the length of hospitalization in patients with erysipelas. MATERIAL AND METHODS This retrospective study included 153 admissions of 135 patients (63 women and 72 men) hospitalized due to erysipelas from January 2010 to December 2019. Clinical symptoms, test results, comorbidities, and antibiotic treatments were taken into consideration as factors affecting the length of hospital stay. RESULTS The median length of hospitalization was 10 days (interquartile range (IQR) = 7-14). Women spent less time in the ward, but the difference was not significant. Features such as tinea pedis (15.5 days, IQR = 13.5-20; p = 0.002), anemia (11 days, IQR = 9-15; p = 0.02), chills (12 days, IQR = 9-15; p = 0.03), elevated serum C-reactive protein (CRP) level over 100 mg/L (11 days, IQR = 8-17; p = 0.02), and leukocytosis (11 days, IQR = 8-15, p = 0.005) were identified as prolonged hospitalization factors. Moreover, patients with erysipelas localized to the legs (p = 0.01) and with a gangrenous variant of erysipelas (p = 0.03) were hospitalized longer. The first-choice antibiotic was not significant in terms of prolonged hospitalization. Patients treated with clindamycin during hospitalization, regardless of whether it was a first-line or subsequent antibiotic, stayed in the ward significantly longer (p = 0.005). CONCLUSION Patients suffering from erysipelas with the features identified above, have a higher risk of a prolonged stay in the hospital. Significantly increased inflammatory factors, anemia and tinea pedis contributed to prolonged hospitalization.
Collapse
Affiliation(s)
- Magdalena Łyko
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Mateusz Kaczmarek
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Polina Nekrasova
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | | | - Joanna Maj
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Alina Jankowska-Konsur
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| |
Collapse
|
4
|
Abstract
This evidence-based review highlights cutaneous infections of bacterial, viral, and fungal origin that are frequently encountered by clinicians in all fields of practice. With a focus on treatment options and management, the scope of this article is to serve as a reference for physicians, regardless of field of specialty, as they encounter these pathogens in clinical practice.
Collapse
Affiliation(s)
- Ana Preda-Naumescu
- School of Medicine, University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Boni Elewski
- Department of Dermatology, University of Alabama at Birmingham, 510 20th Street South, FOT Suite 858, Birmingham, AL 35233, USA
| | - Tiffany T Mayo
- Department of Dermatology, University of Alabama at Birmingham, 510 20th Street South, FOT Suite 858, Birmingham, AL 35233, USA.
| |
Collapse
|
5
|
Gezgin Yildirim D, Seven MB, Gönen S, Söylemezoğlu O. Erysipelas-like erythema in children with familial Mediterranean fever. Clin Exp Rheumatol 2020; 38 Suppl 127:101-104. [PMID: 33124556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Erysipelas-like erythema (ELE) is a well-known pathognomonic skin lesion associated with familial Mediterranean fever (FMF). The aim of this study was to describe the clinical and demographic features and phenotypic differences between paediatric FMF patients with and without ELE. METHODS We retrospectively collected the medical charts of paediatric patients who had been diagnosed with FMF and followed by the Paediatric Rheumatology Department of Gazi University, Turkey, from 2006 to 2016. RESULTS Among 782 FMF patients, 59 (33 males and 26 females; median age, 11.1±5.1) were found to have ELE. More patients had arthritis in the ELE group than in the other group (p=0.011). Arthritis occurred in the ankle (77.4%), knee (19.3%) and hip (3.2%) joints. The coexistence of arthritis and ELE was seen in 12 (20.3%) patients. All ELE plaques were located on the lower legs and dorsum of the feet. Eleven patients (18.6%) presented with ELE as the initial symptom and were diagnosed with FMF, and 48 (81.4%) patients experienced ELE attacks while receiving colchicine therapy. The median dose of colchicine at last visit, PRAS activity score and M694V homozygous mutation status were significantly higher in the ELE group than in the other group (p=0.041, p=0.001 and p=0.023, respectively). CONCLUSIONS ELE is an uncommon but important feature of FMF. In patients with ELE, arthritis is more frequently encountered, and M694V homozygous mutation is more frequently found. FMF patients with ELE have more severe disease activity, and they use higher doses of colchicine in relation to this severe disease course.
Collapse
Affiliation(s)
- Deniz Gezgin Yildirim
- Department of Paediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Mustafa Burak Seven
- Department of Paediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sevim Gönen
- Department of Paediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Oğuz Söylemezoğlu
- Department of Paediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| |
Collapse
|
6
|
Ben Hamou A, Maurou O, Nadler S, Dupuy O. Septic shock with methicillin-sensitive Staphylococcus aureus secondary to continuous subcutaneous insulin infusion by external pump. Diabetes Metab 2020; 47:101165. [PMID: 32461155 DOI: 10.1016/j.diabet.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 11/17/2022]
Affiliation(s)
- A Ben Hamou
- Diabetology, Endocrinology and Nutrition Department, Paris Saint-Joseph Hospital, 75014 Paris, France.
| | - O Maurou
- Diabetology, Endocrinology and Nutrition Department, Paris Saint-Joseph Hospital, 75014 Paris, France
| | - S Nadler
- Diabetology, Endocrinology and Nutrition Department, Paris Saint-Joseph Hospital, 75014 Paris, France
| | - O Dupuy
- Diabetology, Endocrinology and Nutrition Department, Paris Saint-Joseph Hospital, 75014 Paris, France
| |
Collapse
|
7
|
Weiss M, Vignon MD, Lepelletier C, Macaux L, Jachiet M, de Masson A, Bagot M, Bouaziz JD. Vasculitis Mimicking Pseudo Erysipelas in Systemic Lupus Erythematosus. Acta Derm Venereol 2019; 99:1295-1296. [PMID: 31580463 DOI: 10.2340/00015555-3334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Morgane Weiss
- Department of Dermatology, Saint Louis Hospital, , France
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Jeon W, Kim YC, Hong M, Rejinold S, Park K, Yoon I, Yoo S, Lee H, Ahn J. Microcrystalline Cellulose for Delivery of Recombinant Protein-Based Antigen against Erysipelas in Mice. Biomed Res Int 2018; 2018:7670505. [PMID: 29992162 PMCID: PMC6016178 DOI: 10.1155/2018/7670505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/06/2018] [Accepted: 05/03/2018] [Indexed: 11/17/2022]
Abstract
The study describes the development of a vaccine using microcrystalline cellulose (Avicel PH-101) as a delivery carrier of recombinant protein-based antigen against erysipelas. Recombinant SpaA, surface protective protein, from a gram-positive pathogen Erysipelothrix rhusiopathiae was fused to a cellulose-binding domain (CBD) from Trichoderma harzianum endoglucanase II through a S3N10 peptide. The fusion protein (CBD-SpaA) was expressed in Escherichia coli and was subsequently bound to Avicel PH-101. The antigenicity of CBD-SpaA bound to the Avicel was evaluated by enzyme-linked immunosorbent (ELISA) and confocal laser scanning microscope (CLSM) assays. For the examination of its immunogenicity, groups of mice were immunized with different constructs (soluble CBD-SpaA, Avicel coated with CBD-SpaA, whole bacterin of E. rhusiopathiae (positive control), and PBS (negative control)). In two weeks after immunization, mice were challenged with 1x107 CFU of E. rhusiopathiae and Avicel coated with CBD-SpaA induced protective immunity in mice. In conclusion, this study demonstrates the feasibility of microcrystalline cellulose as the delivery system of recombinant protein subunit vaccine against E. rhusiopathiae infection in mice.
Collapse
Affiliation(s)
- Wooyoung Jeon
- Biotechnology Process Engineering Center, KRIBB, Cheongju 363-883, Republic of Korea
| | - Yeu-Chun Kim
- Department of Chemical and Biomolecular Engineering, KAIST, Daejeon 305-701, Republic of Korea
| | - Minhee Hong
- Biotechnology Process Engineering Center, KRIBB, Cheongju 363-883, Republic of Korea
| | - Sanoj Rejinold
- Department of Chemical and Biomolecular Engineering, KAIST, Daejeon 305-701, Republic of Korea
| | - Kyoungmoon Park
- Biological and Chemical Engineering, Hongik University, Sejong 339-701, Republic of Korea
| | - Injoong Yoon
- Choong-Ang Vaccine Laboratory, Daejeon 305-348, Republic of Korea
| | - Sungsik Yoo
- Choong-Ang Vaccine Laboratory, Daejeon 305-348, Republic of Korea
| | - Hongweon Lee
- Biotechnology Process Engineering Center, KRIBB, Cheongju 363-883, Republic of Korea
- University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon 305-350, Republic of Korea
| | - Jungoh Ahn
- Biotechnology Process Engineering Center, KRIBB, Cheongju 363-883, Republic of Korea
- University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon 305-350, Republic of Korea
| |
Collapse
|
9
|
Affiliation(s)
- Ulrich Seybold
- Sektion Klinische Infektiologie, Med. Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Univ., LMU München, Pettenkoferstr. 8a, D-80336 , München, Deutschland.
| | - Hans Stubbe
- Sektion Klinische Infektiologie, Med. Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Univ., LMU München, Pettenkoferstr. 8a, D-80336 , München, Deutschland
| | - Rika Draenert
- Sektion Klinische Infektiologie, Med. Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Univ., LMU München, Pettenkoferstr. 8a, D-80336 , München, Deutschland
| | - Johannes R Bogner
- Sektion Klinische Infektiologie, Med. Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Univ., LMU München, Pettenkoferstr. 8a, D-80336 , München, Deutschland
| |
Collapse
|
10
|
Ioffe I, Zelenyi I, Meleshchenko A, Meleshchenko N, Karpenko P. INDEXES OF CYTOKINE PROFILE OF BLOOD IN PATIENTS WITH COMPLICATED ERYSIPELAS. Georgian Med News 2018:13-18. [PMID: 29461220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The cytokine blood profile in patients with complicated erysipelas was investigated. It was found that in patients with complications of erysipelas (gangrene, phlegmon, abscess, thrombophlebitis of the subcutaneous veins of the shin) levels of pro-inflammatory cytokines IL-1ß, TNF-α, IL-2, IL-6 in serum significantly increase and level of anti-inflammatory cytokine IL-4 increases slightly, as well as was found a significant increase in coefficients reflecting the ratio of pro-inflammatory and anti-inflammatory cytokines, which indicates the prevalence in the blood of examined patients with complications of erysipelas an anti-inflammatory properties. A more significant increase in pro-inflammatory cytokines serum levels is typical for patients with destructive forms of erysipelas - phlegmonous and gangrenous, a slight increase - for patients without purulent-necrotic component of complication (thrombophlebitis of the subcutaneous veins of the shin). In the future we plan to study pharmacological correction of shifts in cytokine blood profile with drugs with immunomodulating properties in patients with complicated erysipelas.
Collapse
Affiliation(s)
- I Ioffe
- State Establishment "Lugansk State Medical University", Rubizhne, Lugansk region, Ukraine
| | - I Zelenyi
- State Establishment "Lugansk State Medical University", Rubizhne, Lugansk region, Ukraine
| | - A Meleshchenko
- State Establishment "Lugansk State Medical University", Rubizhne, Lugansk region, Ukraine
| | - N Meleshchenko
- State Establishment "Lugansk State Medical University", Rubizhne, Lugansk region, Ukraine
| | - P Karpenko
- State Establishment "Lugansk State Medical University", Rubizhne, Lugansk region, Ukraine
| |
Collapse
|
11
|
Villefrance M, Høgh A, Kristensen LH. [Compression is important in erysipelas treatment]. Ugeskr Laeger 2017; 179:V04170284. [PMID: 28992840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Erysipelas is a common skin infection involving the lymphatic vessels, which induces an oedema. This has a tendency of persisting after infection is treated. The lymphatic system plays an important role in the immune system, and the impaired lymph drainage leads to a state of local immune deficiency. This is essential to the pathogenesis of recurrent erysipelas, as each episode of erysipelas further damages the lymphatic system and increases the risk of a new infection. This vicious circle makes it important to treat both erysipelas and oedema appropriately to reduce recurrence and morbidity.
Collapse
|
12
|
|
13
|
Karlsson M, Tarp B. [Facial erysipelas requiring intubation]. Ugeskr Laeger 2016; 178:V67852. [PMID: 27460575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
14
|
Ferreira A, Bolland MJ, Thomas MG. Meta-analysis of randomised trials comparing a penicillin or cephalosporin with a macrolide or lincosamide in the treatment of cellulitis or erysipelas. Infection 2016; 44:607-15. [PMID: 27085865 DOI: 10.1007/s15010-016-0895-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/04/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE Beta-lactam antibiotics, such as penicillin, flucloxacillin or cephalexin, are widely considered first-line treatment for cellulitis and erysipelas, while macrolides and lincosamides, such as erythromycin, azithromycin or clindamycin, are widely considered second-line agents. We attempted to determine whether outcomes differed between patients treated either with a beta-lactam or with a macrolide or lincosamide. METHODS We conducted a meta-analysis of published trials in which patients with cellulitis or erysipelas were randomised to treatment either with a beta-lactam or with a macrolide or lincosamide. We searched PUBMED, EMBASE, MEDLINE and SCOPUS (up to March 2014) using the terms: cellulitis/erysipelas, penicillin/beta-lactam, macrolide/lincosamide, random*/controlled*/trial* as keywords. We included randomised trials that compared monotherapy with a beta-lactam with monotherapy with a macrolide or lincosamide for cellulitis or erysipelas. RESULTS We identified 15 studies, 9 in patients with cellulitis or erysipelas and 6 in patients with various skin and soft tissue infections including cellulitis and erysipelas. The efficacy of treatment of cellulitis or erysipelas was similar with a beta-lactam [27/221 (12 %) not cured] and a macrolide or lincosamide [21/241 (9 %) not cured, RR 1.24, 95 % CI 0.72-2.41, p = 0.44]. Treatment efficacy was also similar for skin or soft tissue infections including cellulitis and erysipelas (RR 1.28, 95 % CI 0.96-1.69, p = 0.09). Risk of adverse effects was similar for beta-lactams [148/1295 (11 %) not cured] and macrolides or lincosamides [228/1737 (13 %) not cured, RR 0.86, 95 % CI 0.64-1.16, p = 0.31]. CONCLUSION Treatment with a macrolide or lincosamide for cellulitis or erysipelas has a similar efficacy and incidence of adverse effects as treatment with a beta-lactam.
Collapse
Affiliation(s)
- Athena Ferreira
- Department of Infectious Diseases, Auckland City Hospital, Auckland, 1142, New Zealand
| | - Mark J Bolland
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, 1142, New Zealand
| | - Mark G Thomas
- Department of Infectious Diseases, Auckland City Hospital, Auckland, 1142, New Zealand.
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, 1142, New Zealand.
| |
Collapse
|
15
|
Belyaeva OA, Shendrik VG, Kuznetsova LV. [INDICATORS OF PHAGOCYTIC ACTIVITY OF MONOCYTES AND CYTOKINE PROFILE IN PATIENTS WITH ERYSIPELAS OF VARYING SEVERITY]. Klin Khir 2016:54-57. [PMID: 30256595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Erysipelas (PB) — a serious disease that is accompanied by severe complications and high lethality. The immunological investigations were carry out in 51 patients who were treated at the clinic for erysipelas with an immunomodulator application. Marked changes in the indices of phagocytic activity of monocytes (PHAM) and the cytokine profile in patients with erysipelas were note. Application in complex treatment of immunomodulator give the positive effect on the indices of PHAM.
Collapse
|
16
|
Steurer J. [Clindamycin vs. trimethoprim-sulfamethoxazole: equally effective in skin infections]. Praxis (Bern 1994) 2015; 104:645-646. [PMID: 26098243 DOI: 10.1024/1661-8157/a002027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Johann Steurer
- 1 Horten-Zentrum für praxisorientierte Forschung und Wissenstransfer, Universitätsspital Zürich
| |
Collapse
|
17
|
Zürcher S, Trellu LT. [Recurrent erysipelas and cellulitis: management]. Rev Med Suisse 2015; 11:759-762. [PMID: 26021136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Erysipelas and infectious cellulitis are skin infections that develop following the entry of bacteria through gaps in the skin. The most common complication is recurrence. Control of predisposing factors remains essential to prevent it. Prophylactic antibiotics are sometimes prescribed, but this approach is based on small studies and expert opinion. This article reflects the current state of knowledge and the standard of care.
Collapse
|
18
|
Breuer GS, Taurog JD. Erysipelas-like erythema in a patient with familial Mediterranean fever. J Rheumatol 2014; 41:2271-2272. [PMID: 25362709 DOI: 10.3899/jrheum.140324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Gabriel S Breuer
- Head, Rheumatology Unit, Shaare Zedek Medical Center, Clinical Senior Lecturer, Hebrew University School of Medicine, Jerusalem, Israel;
| | - Joel D Taurog
- Professor, Rheumatic Diseases Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
19
|
Pereira De Godoy JM, Ribeiro A, Cozzetto De Oliveira AL, Batigalia F. Penicillin as a therapeutic option in the treatment of in-hospital erysipelas. GIORN ITAL DERMAT V 2014; 149:150-151. [PMID: 24566577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- J M Pereira De Godoy
- Department of the Medicine School in São José do Rio Preto-FAMERP, and CNPq (National Council for Research and Development), Brazil -
| | | | | | | |
Collapse
|
20
|
Frøslev-Friis C, Kliment H, Andersen JDH. [Severe thrombocytopenia after diagnosis of deep venous thrombosis]. Ugeskr Laeger 2013; 175:1875-1877. [PMID: 23937877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A patient presented with erysipelas and developed deep venous thrombosis (DVT) and later idiopatic thrombocytopenic purpura (ITP). In the literature we find no reports of ITP following DVT. It is well known that patients can develop HIT after DVT or DVT after ITP, both caused by the medicine used for treatment. Patients have developed ITP after heparin-induced thrombocytopenia (HIT). Cases are also described in which heparin antibodies are found, but in which the final diagnosis was ITP. The diagnosis of the patient in our case story could be ITP based on DVT, but with no history of HIT. Alternatively, he could have developed two complications to an infection.
Collapse
|
21
|
Fernando SL. Ertapenem-induced acute generalized exanthematous pustulosis with cross-reactivity to other beta-lactam antibiotics on patch testing. Ann Allergy Asthma Immunol 2013; 111:139-40. [PMID: 23886234 DOI: 10.1016/j.anai.2013.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/20/2013] [Accepted: 05/20/2013] [Indexed: 11/19/2022]
|
22
|
Abstract
Skin- and Soft tissue infections are a frequent problem in hospital as well as in ambulatory care. Diagnostic procedures and treatment principles have to include the most frequent pathogens. While the acute forms of skin and soft tissue infections, with, necrotising fasciitis as important exception, rarely cause diagnostic or therapeutic problem, the treatment of patients with recurrent furunculosis, chronic wounds and diabetic feet is often difficult and frustration for patients and physicians. This article gives an overview of the most important problems and treatment strategies.
Collapse
Affiliation(s)
- R J Piso
- Medizinische Klinik, Kantonsspital Olten.
| | | |
Collapse
|
23
|
Zelenyĭ II, Frolov VM, Peresadin NA. [Effectiveness of Reamberin in correction of oxidative stress syndrome in patients with phlegmonous and gangrenous erysipelas against the background of the 2 type diabetes mellitus]. Vestn Khir Im I I Grek 2012; 171:54-58. [PMID: 23488264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The influence of modern detoxic preparation Reamberin on indicators of oxidative stress syndrome (OSS)--the content of lipoperoxidation products was investigated. It was established that inclusion of Reamberin in the complex of surgical treatment of destructive forms of erysipelas on the background of type 2 DM accelerates the liquidation of OSS.
Collapse
|
24
|
Mahé E, Zimmermann U. [Significant improvement in ulcerative necrobiosis lipoidica with doxycycline]. Ann Dermatol Venereol 2011; 138:686-8. [PMID: 21978507 DOI: 10.1016/j.annder.2011.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 09/01/2010] [Accepted: 02/21/2011] [Indexed: 11/29/2022]
|
25
|
Naveen KN, Pai VV, Sori T, Kalabhavi S. Erysipelas after breast cancer treatment. Breast 2011; 21:218-9. [PMID: 21925882 DOI: 10.1016/j.breast.2011.08.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 08/29/2011] [Indexed: 11/17/2022] Open
|
26
|
van der Waal RIF. [Erysipelas]. Ned Tijdschr Tandheelkd 2011; 118:308. [PMID: 21766527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- R I F van der Waal
- Afdeling Dermatologie, St. Antonius Ziekenhuis, Koekoekslaan 1, 3435 CM Nieuwegein
| |
Collapse
|
27
|
Saka B, Kombaté K, Mouhari-Toure A, Akakpo S, Boukari T, Pitché P, Tchangaï-Walla K. [Bacterial dermohypodermitis and necrotizing fascitis: 104-case series from Togo]. Med Trop (Mars) 2011; 71:162-164. [PMID: 21695874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The purpose of this retrospective study was to obtain data on the epidemiology, clinical features, and outcome of bacterial dermohypodermitis (BDH) observed in a hospital setting hospital in Lomé, Togo. Cases of BDH treated in dermatology and internal medicine of the Lomé university hospital center from January 1999 to December 2009 were reviewed. A total of 104 patients were hospitalized for BDH during the study period. Mean patient age was 42.9 +/- 16.1 years and sex ratio (M/F) was 0.89. Infection by HIV was detected in 10 of 37 patients in whom serology was performed. The site of erysipelas was located on the legs and feet in 93 cases (89.4%), entire lower limb in 4 (3.9%), upper limbs in 4 (3.9%), thighs in 2 (1.9%), and buttock in 1 (0.9%). The main local and systemic risk factors were existence of an entry site in 89 cases, use of depigmenting drugs in 11, HIV infection in 10, previous history of erysipelas in 9 cases, and lymphoedema in 8. First-line treatment used penicillin G in 90 cases. Seven patients presented necrotizing fasciitis. Necrotizing fasciitis was associated with HIV infection in 2 cases, use of non-steroidal anti-inflammatory drugs (NSAID) in 2, and use of depigmenting drugs in one. Two deaths were recorded in the necrotizing fasciitis group including one HIV-infected patient. Recurrence was observed in 8 patients and secondary complications such as lower limb elephantiasis occurred in 7 patients.
Collapse
Affiliation(s)
- B Saka
- Service de dermatologie, CHU Tokoin, Lomé, Togo.
| | | | | | | | | | | | | |
Collapse
|
28
|
Vanhooteghem O, Szepetiuk G, Paurobally D, Heureux F. Chronic interdigital dermatophytic infection: a common lesion associated with potentially severe consequences. Diabetes Res Clin Pract 2011; 91:23-5. [PMID: 21035887 DOI: 10.1016/j.diabres.2010.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 08/10/2010] [Accepted: 09/20/2010] [Indexed: 11/18/2022]
Abstract
Interdigital intertrigo and onychomycosis has the potential cause of severe bacterial infectious complications with pain, mobility problems, abscess, erysipelas, cellulitis, fasciitis and osteomyelitis. In another hand, diabetic neuropathy, which affects 60-70% of those with diabetes mellitus, is one of the most troubling complications for persons with diabetes. These people are high suspecting to be infected by dermatophytic infections in interdigital spaces or onychomycosis witch are frequently induce damage to the stratum corneum, leading to bacterial proliferation and secondary infection. A patient presented with an asymptomatic warm, painless, erythematous swelling of the second left toe, which had been present for a few weeks. Clinically, the lesion was categorized as erysipelas upon an insidious abscess formation. Further investigation was undertaken to confirm the presence of diabetes. Leg erysipelas is a common affection which, according to various studies, has both local concomitants (interdigital intertrigo, lymphoedema, surgical antecedents) and/or general causes (immune suppression, diabetes, alcoholism, etc). Interdigital intertrigo, tinea pedis, and onychomycosis present as public health problems that could trigger serious deterioration in patient quality of life, due to complications induced by secondary bacterial infections.
Collapse
|
29
|
Zelenyĭ II, Frolov VM, Peresadin NA. [Estimation of efficiency reamberin in the correction of endogenous intoxication syndrome at the patients with the phlegmonous and gangrenous forms of erysipelas on background diabetes mellitus at their surgical treatment]. Khirurgiia (Mosk) 2011:82-86. [PMID: 22408807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The influence of modern detoxic preparation reamberin on indicators of the of endogenous intoxication syndrome (EIS)--the level of average molecules, malon dialdehyde, cyrcukatiry immune complexes and its fractional composition in blood serum of the patients with destructive forms of erysipelas--phlegmonous and gangrenous on background diabetes mellitus (DM). It is established that the inclusion of reamberin in the complex surgical treatment of destructive forms of erysipelas on background DM accelerates the elimination of SEI. From this we can recommend the use of reamberin in the complex surgical treatment of complicated forms of erysipelas on background DM.
Collapse
|
30
|
Chang FB. Painful rash on face. J Fam Pract 2010; 59:459-462. [PMID: 20714456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
First came a sore throat. Then came a warm, erythematous rash on the patient's face. A 68-year-old woman came into the clinic for treatment of a painful, erythematous skin rash over the bridge of her nose. She'd had the rash for 4 days, and it was spreading to the malar area and up around her eyelids and forehead.
Collapse
Affiliation(s)
- Felix B Chang
- Fitchburg Family Medicine Residency Program, University of Massachusetts School of Medicine, Worcester, MA, USA.
| |
Collapse
|
31
|
Abstract
BACKGROUND Cellulitis and erysipelas are now usually considered manifestations of the same condition, a skin infection associated with severe pain and systemic symptoms. A range of antibiotic treatments are suggested in guidelines. OBJECTIVES To assess the efficacy and safety of interventions for non-surgically-acquired cellulitis. SEARCH STRATEGY In May 2010 we searched for randomised controlled trials in the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, and the ongoing trials databases. SELECTION CRITERIA We selected randomised controlled trials comparing two or more different interventions for cellulitis. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. MAIN RESULTS We included 25 studies with a total of 2488 participants. Our primary outcome 'symptoms rated by participant or medical practitioner or proportion symptom-free' was commonly reported. No two trials examined the same drugs, therefore we grouped similar types of drugs together.Macrolides/streptogramins were found to be more effective than penicillin antibiotics (Risk ratio (RR) 0.84, 95% CI 0.73 to 0.97). In 3 trials involving 419 people, 2 of these studies used oral macrolide against intravenous (iv) penicillin demonstrating that oral therapies can be more effective than iv therapies (RR 0.85, 95% CI 0.73 to 0.98).Three studies with a total of 88 people comparing a penicillin with a cephalosporin showed no difference in treatment effect (RR 0.99, 95% CI 0.68 to 1.43).Six trials which included 538 people that compared different generations of cephalosporin, showed no difference in treatment effect (RR 1.00, 95% CI 0.94 to1.06).We found only small single studies for duration of antibiotic treatment, intramuscular versus intravenous route, the addition of corticosteroid to antibiotic treatment compared with antibiotic alone, and vibration therapy, so there was insufficient evidence to form conclusions. Only two studies investigated treatments for severe cellulitis and these selected different antibiotics for their comparisons, so we cannot make firm conclusions. AUTHORS' CONCLUSIONS We cannot define the best treatment for cellulitis and most recommendations are made on single trials. There is a need for trials to evaluate the efficacy of oral antibiotics against intravenous antibiotics in the community setting as there are service implications for cost and comfort.
Collapse
Affiliation(s)
- Sally A Kilburn
- School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, Hampshire, UK, PO1 2FR
| | | | | | | |
Collapse
|
32
|
Velciov S, Gluhovschi G, Feier V, Curescu M, Trandafirescu V, Petrică L, Gluhovschi C, Bob F, Bozdog G, Gadalean F, Florescu C, Bobu M, Chiliban A. Elements of renal injury in patients with erysipelas. Rom J Intern Med 2010; 48:179-185. [PMID: 21428183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Erysipelas is an infectious disease caused by group A beta hemolytical streptococci which may produce renal lesions, most frequently glomerular disease. Renal injury although known is less studied in practice. Rarely bioptical exams have been performed, thus the problem of the relationship erysipelas glomerular disease is practically not solved. The aim of this study was a cross-sectional analysis of renal involvement produced by erysipelas in two departments where patients with erysipelas are diagnosed and treated: Dermatology and Infectious Diseases. We investigated 166 patients (86M, 80F; mean age 61.66 +/- 18.42) with erysipelas hospitalized in the Departments of Dermatology (55 patients-33%) and Infectious Diseases (111 patients-66%) during 2005-2009. The diagnosis was established on clinical and biological data. In these patients clinical and biological exam has been performed. We assessed GFR and urinalysis (hematuria and proteinuria). The control group consisted of 110 apparently healthy persons. Of the 166 patients with erysipelas we found asymptomatic urinary abnormalities in 82 (47%), isolated proteinuria in 19 (11%) patients and proteinuria associated with hematuria in 21 (13%) patients, and isolated hematuria in 38 (23%) patients. We did not find patients with nephrotic or nephritic syndrome. In the control group we found asymptomatic urinary abnormalities in 25 (23%) of the patients. A statistically significant difference was between the two groups (p < 0.01). Asymptomatic urinary abnormalities have been more frequent in patients with erysipelas from the Infectious Diseases Department compared to those from the Dermatology Department. A statistically significant difference has been found (p < 0.03). In patients with recurrent erysipelas (43 patients-26%) we found asymptomatic urinary abnormalities in 26 (54%) of the patients compared to the presence of asymptomatic urinary abnormalities in patients with acute erysipelas in 56 out of 123 (46%). Mean GFR in patients with erysipelas was of 73.94 +/- 27.79 ml/min. It was lower in patients with recurrent erysipelas, 72.13 +/- 24.74 mL/min respectively. Association of proteinuria with hematuria was more frequent in patients with recurrent erysipelas. Patients with asymptomatic urinary abnormalities during the course of erysipelas need to be closely monitored during antibiotic treatment.
Collapse
|
33
|
Vos MD, Bos RRM, Vissink A. [A sudden redness and swelling of the face]. Ned Tijdschr Tandheelkd 2009; 116:383-386. [PMID: 19673238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Two patients were referred to a department of oral and maxillofacial surgery with a redness and swelling of the face which had suddenly developed together with a mild illness. The diagnosis of erysipelas was made clinically. This skin infection is generally caused by betahaemolytic streptococci group-A. Treatment is generally in the first instance medicinal. The drugs of choice for treating erysipelas in the vast majority of cases are narrow-spectrum penicillins.
Collapse
Affiliation(s)
- M D Vos
- Universitair Medisch Centrum, Groningen.
| | | | | |
Collapse
|
34
|
Eich G. [Comment on rule number 1 in Praxis no.1]. Praxis (Bern 1994) 2009; 98:371-373. [PMID: 19340767 DOI: 10.1024/1661-8157.98.7.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- G Eich
- Abteilung Infektiologie und Spitalhygiene, Stadtspital Triemli, Zürich.
| |
Collapse
|
35
|
Pertel PE, Eisenstein BI, Link AS, Donfrid B, Biermann EJA, Bernardo P, Martone WJ. The efficacy and safety of daptomycin vs. vancomycin for the treatment of cellulitis and erysipelas. Int J Clin Pract 2009; 63:368-75. [PMID: 19222623 PMCID: PMC2705813 DOI: 10.1111/j.1742-1241.2008.01988.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Results from previous trials suggest that daptomycin may result in faster clinical improvement than penicillinase-resistant penicillins or vancomycin for patients with complicated skin and skin structure infections. OBJECTIVE The objective was to evaluate whether daptomycin treatment of cellulitis or erysipelas would result in faster resolution compared with vancomycin. DESIGN The study was a prospective, evaluator-blinded, multi-centre trial. Patients were randomised to receive daptomycin 4 mg/kg once daily or vancomycin according to standard of care for 7-14 days. PATIENTS Adults diagnosed with cellulitis or erysipelas requiring hospitalisation and intravenous antibiotic therapy were eligible for enrolment. RESULTS The clinical success rates were 94.0% for daptomycin and 90.2% for vancomycin (95% confidence interval for the difference, -6.7%, 14.3%). There were no statistically significant differences between treatment arms in the time to resolution or improvement in any of the predefined clinical end-points. Both daptomycin and vancomycin were well tolerated. CONCLUSIONS There was no difference in the rate of resolution of cellulitis or erysipelas among patients treated with daptomycin or vancomycin. Daptomycin 4 mg/kg once daily appeared to be effective and safe for treating cellulitis or erysipelas.
Collapse
Affiliation(s)
- P E Pertel
- Clinical Research, Cubist Pharmaceuticals, Lexington, MA 02421, USA.
| | | | | | | | | | | | | |
Collapse
|
36
|
Badger CMA, Preston NJ, Seers K, Mortimer PS. WITHDRAWN: Antibiotics / anti-inflammatories for reducing acute inflammatory episodes in lymphoedema of the limbs. Cochrane Database Syst Rev 2009:CD003143. [PMID: 19160218 DOI: 10.1002/14651858.cd003143.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Lymphoedema is a chronic, progressive condition and one area of debate is the optimum management for infective/inflammatory episodes (AIE's). OBJECTIVES To determine whether antibiotic/anti-inflammatory drugs given prophylactically reduce the number and severity of AIE's in patients with lymphoedema. SEARCH STRATEGY We searched the Cochrane Breast Cancer Group register in September 2003, the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2003), CINAHL, MEDLINE, PASCAL, SIGLE, UnCover, reference lists produced by The British Lymphology Society, the National Research Register (NRR) and the International Society of Lymphology congress proceedings. SELECTION CRITERIA Randomised controlled trials testing an antibiotic or anti-inflammatory drug against placebo (with or without physical therapies) were included. DATA COLLECTION AND ANALYSIS Eligibility for inclusion was confirmed by two blinded reviewers. The papers were screened independently using a checklist of criteria relating to quality. Both reviewers extracted data from the eligible studies using a data extraction form. MAIN RESULTS Four studies (364 randomised patients) were included. Two studied the effects of intensive physical treatment plus selenium or placebo in preventing AIE's, and two studied the effects of Ivermectin, Diethylcarbamazine (DEC) (anti-filarial agents) and penicillin as prophylactic treatment for adeno lymphangitis(ADL) versus placebo.Both selenium trials reported no inflammatory episodes during the trial period in the treated group but one case of infection in the two placebo groups respectively. Seven additional cases of infection in trial one and 14 cases in trial two required treatment in the three month follow up period.One anti-filarial trial reported 127 ADL episodes for all groups during the treatment year (compared with 684 episodes during the pre-treatment year). There were 228 ADL episodes during the trial follow-up year but no findings were significant. No link was found between the grade of oedema and the frequency of ADL episodes. There was a significant link between increased episodes and the rainy season. Penicillin reduced the mean number of inflammatory episodes from 4.6 to 0.5 after treatment, which increased to 1.9 at the end of follow-up. AUTHORS' CONCLUSIONS The effectiveness of selenium in preventing AIE in lymphoedema remains inconclusive in the absence of properly conducted randomised-controlled trials. Anti-filarials do not appear to reduce ADL episodes in filarial lymphoedema. Penicillin appears to contribute to a significant reduction in ADL when combined with foot-care. The importance of foot-care should be recommended, which may also apply to care of the arm following breast cancer treatment. Properly conducted trials are needed to demonstrate any efficacy of these interventions.
Collapse
Affiliation(s)
- Caroline M A Badger
- Institute Research Team, Royal College of Nursing Institute, RCN Institute, 20 Cavendish Square, London, UK, W1M 0AB
| | | | | | | |
Collapse
|
37
|
Byrd T. A rapidly spreading rash on a child. Strep infections, gastroenteritis precede symptoms. Adv Nurse Pract 2008; 16:24-25. [PMID: 19999049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Teresa Byrd
- Ocean City Family Practice, Ocean City, NJ, USA
| |
Collapse
|
38
|
olde Hartman TC, Uijen AA. [The practice guideline 'Bacterial skin infections' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice]. Ned Tijdschr Geneeskd 2008; 152:1602-1603. [PMID: 18998264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The revised guideline 'Bacterial skin infections' from the Dutch College ofGeneral Practitioners offers a clear and extensive overview of the most prevalent superficial and deep bacterial infections in general practice. Given the lack of evidence, it is no longer recommended to keep children with impetigo out of school or daycare centres. Erysipelas and cellulitis are now considered variants of the same bacterial infection and require the same therapy. Due to its rising prevalence, methicillin-resistant Staphylococcus aureus should also be considered. In conclusion, the guideline is a practical and evidence-based tool for the diagnosis, education and treatment of bacterial skin infections.
Collapse
Affiliation(s)
- T C olde Hartman
- Universitair Medisch Centrum St Radboud, afd. Huisartsgeneeskunde, Postbus 9101, 6500 HB Nijmegen.
| | | |
Collapse
|
39
|
Sanders CJG, Bruijnzeel-Koomen CAFM. [The practice guideline 'Bacterial skin infections' (first revision) from the Dutch College of General Practitioners; a response from the perspective of dermatology]. Ned Tijdschr Geneeskd 2008; 152:1604-1605. [PMID: 18998265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We reviewed the first revision of the clinical practice guidelines on the management of bacterial skin infections developed by the Dutch College of General Practitioners. Bacterial skin infections are subdivided into superficial and deep infections; the former are often treated locally while the latter may require systemic antibiotics or surgical intervention. The rate of infection with methicillin-resistant Staphylococcus aureus (MRSA) in the community is relatively low in The Netherlands, but the guideline provides recommendations, such as the restricted use of mupirocin ointment, to facilitate future MRSA control measures. Clinical distinction between erysipelas and cellulitis is often impossible; therefore, the term cellulitis is used throughout the guideline and refers to both Staphylococcus aureus and Streptococcus pyogenes infections of the skin and subcutaneous tissue. The first line of therapy for cellulitis remains a small spectrum, beta-lactamase resistant penicillin, such as flucloxacillin for 10 days. There are no conclusive studies on the prevention of recurrent cellulitis, so recommendations are based on expert opinion and pathophysiological considerations. The lack of rigorous and controlled studies often precludes making clear evidence-based recommendations. However, this guideline succeeds remarkably well in combining the available evidence and formulating sound practical management advice for bacterial skin infections in primary care in The Netherlands. It deserves widespread implementation among general practitioners.
Collapse
Affiliation(s)
- C J G Sanders
- Universitair Medisch Centrum Utrecht, afd. Dermatologie en Allergologie, Huispost G02.124, Heidelberglaan I00, 3584 CX Utrecht.
| | | |
Collapse
|
40
|
Morris AD. Cellulitis and erysipelas. BMJ Clin Evid 2008; 2008:1708. [PMID: 19450336 PMCID: PMC2907977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Cellulitis is a common problem, caused by spreading bacterial inflammation of the skin, with redness, pain, and lymphangitis. Up to 40% of affected people have systemic illness. Erysipelas is a form of cellulitis with marked superficial inflammation, typically affecting the lower limbs and the face. The most common pathogens in adults are streptococci and Staphylococcus aureus. Cellulitis and erysipelas can result in local necrosis and abscess formation. Around a quarter of affected people have more than one episode of cellulitis within 3 years. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for cellulitis and erysipelas? What are the effects of treatments to prevent recurrence of cellulitis and erysipelas? We searched: Medline, Embase, The Cochrane Library and other important databases up to May 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS We found 14 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, comparative effects of different antibiotic regimens, duration of antibiotics, and treatment of predisposing factors.
Collapse
|
41
|
Ezzine Sebai N, Hicheri J, Trojjet S, Khaled A, Badri T, Zeglaoui F, Fezaa B, Ridha Kamoun M. [Systemic corticosteroids and their place in the management of hemorrhagic erysipelas]. Tunis Med 2008; 86:49-52. [PMID: 19472700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Haemorrhagic erysipelas is a recently described clinical condition. AIM Our aim is to study the clinical and evolutive particularities of haemorrhagic erysipelas treated with adjuvant corticotherapy. METHODS It's a retrospective study of 6 cases of erysipelas of the lower limbs with serious local signs (purpura, bullae, petechia). RESULTS Surgical examination as well as evaluation of muscular enzymes blood level were achieved in all cases. Adequate antibiotherapy and rapidly degressive systemic corticosteroids (0.5 mg/Kg daily) were prescribed. Fever, pain and cutaneous signs regressed rapidly. Haemorrhagic erysipelas is different from common erysipelas by the presence of serious local signs (bullae, purpura), by its bad response to adequate antibiotics and by its response to systemic steroids.
Collapse
|
42
|
Celestin R, Brown J, Kihiczak G, Schwartz RA. Erysipelas: a common potentially dangerous infection. Acta Dermatovenerol Alp Pannonica Adriat 2007; 16:123-127. [PMID: 17994173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Erysipelas is an acute superficial cutaneous cellulitis that commonly occurs not only in elderly and immunocompromised persons, but also in neonates and small children subsequent to bacterial inoculation through a break in the skin barrier. Group A Beta-hemolytic streptococcus (GABHS, Streptoccocus pyogenes) is the usual etiologic agent. Factors that predispose pediatric patients to the development of erysipelas include very young age, diabetes mellitus, an immunocompromised state, and nephrotic syndrome. Patients typically have a well-demarcated, erythematous, indurated, rapidly spreading patch with a palpable advancing border on the face or extremities. Fever with chills and general malaise may be prominent symptoms. Antibiotics are usually effective. Patients handled in a timely manner tend to recover without problems. However, potential complications include abscess formation, necrotizing fasciitis, septicemia, recurrent infection, and lymphedema.
Collapse
Affiliation(s)
- R Celestin
- New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103-2714, USA
| | | | | | | |
Collapse
|
43
|
Abstract
We report a 6-year-old boy with a diffuse acute pustular eruption which appeared after an erysipela. On the basis of the history and clinical features we made a diagnosis of pustulosis acuta generalisata. An 8-day antibiotic course with amoxicillin and clavulanic acid was instituted. After 1 week the erysipela and the pustular eruption had healed and no relapse of the rash occurred in the following month.
Collapse
Affiliation(s)
- Annalisa Patrizi
- Division of Dermatology, Department of Specialistic and Experimental Clinical Medicine, University of Bologna, Bologna, Italy.
| | | | | | | | | |
Collapse
|
44
|
Cichowitz A, Stanley PA, Morrison WA. Erysipelas-like inflammation following breast surgery. J Plast Reconstr Aesthet Surg 2007; 60:490-4. [PMID: 17399657 DOI: 10.1016/j.bjps.2006.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Accepted: 04/29/2006] [Indexed: 11/18/2022]
Abstract
Impaired lymph drainage is an inevitable consequence of any form of surgery that disrupts lymphatics, resulting in a degree of lymphoedema that may vary from subtle to dramatic and although classically involving an entire limb, may be more localised, confined to only a small area such as a skin flap. Infection is a well-recognised complication of lymphoedema. However, not all inflammatory episodes occurring in the setting of lymphatic dysfunction can be clearly attributed to infection as this article demonstrates. Five patients presented over a 5-year period with distinctive erysipelas-like inflammation affecting the breast which occurred several weeks following reduction mammaplasty in four patients and breast reconstruction in one patient. No clinical response was obtained with standard antibiotics. This inflammatory problem may represent a previously unreported complication of breast surgery with an incidence of 4% following reduction mammaplasty. Recent research supports the notion that this type of episode is most likely to be due to a non-infective inflammatory process related to lymphatic dysfunction induced by surgery.
Collapse
Affiliation(s)
- A Cichowitz
- Department of Surgery, University of Melbourne, St. Vincent's Hospital, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
| | | | | |
Collapse
|
45
|
Buckland GT, Carlson JA, Meyer DR. Persistent periorbital and facial lymphedema associated with Group A beta-hemolytic streptococcal infection (erysipelas). Ophthalmic Plast Reconstr Surg 2007; 23:161-3. [PMID: 17413641 DOI: 10.1097/01.iop.0000256161.79015.38] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chronic lymphedema is both a risk factor for and consequence of erysipelas (cellulitis). We report a case of a 62-year-old woman with rheumatoid arthritis treated with etanercept and prednisone, who developed chronic periorbital lymphedema 2 months after Group A beta-hemolytic streptococcus infection of the face. She had significant ptosis OS and thickened, hyperpigmented periorbital skin. Biopsies were consistent with chronic lymphedema. Of note, on 6 months follow-up, the patient's appearance was improved though she still had residual ptosis. A period of extended observation may be warranted in these cases.
Collapse
Affiliation(s)
- Golden T Buckland
- Department of Ophthalmology, Division of Dermatology and Dermatopathology, Albany Medical College, Albany, New York, USA.
| | | | | |
Collapse
|
46
|
Abstract
PURPOSE OF REVIEW Acute bacterial skin infections are very common, with various presentations and severity. This review focuses on deep skin infections. We separate acute nonnecrotizing infections of the hypodermis (erysipelas), forms with abscesses or exudates and necrotizing fasciitis. These three types actually differ in risk factors, bacteriology, treatment and prognosis. RECENT FINDINGS Leg erysipelas/cellulitis occurs in more than one person/1000/year. It remains mainly due to streptococci. Foot intertrigo is an important risk factor. Necrotizing fasciitis is much rarer and usually occurs in patients with chronic diseases. Staphylococci, especially community-acquired methicillin-resistant strains in some areas, play a growing role in the intermediate form of cellulitis with abscesses and exudates. For erysipelas or noncomplicated cellulitis, antibiotic treatment at home, when feasible, is much less expensive and as effective as hospital treatment. Intermediate cases with collections and exudates often require surgical drainage. For necrotizing fasciitis early surgery remains essential in order to decrease the mortality rate. SUMMARY Antibiotic treatment of deep skin infections must be active on streptococci; the choice of a larger spectrum of activity depends on clinical presentation, risk factors and the burden of methicillin-resistant staphylococci in the environment.
Collapse
|
47
|
Koster JB, Kullberg BJ, van der Meer JWM. Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies. Neth J Med 2007; 65:89-94. [PMID: 17387234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Erysipelas is a distinctive type of superficial cellulitis of the skin with prominent lymphatic involvement, generally caused by group A streptococci. A substantial proportion of patients experience recurrences of erysipelas, and this may be a reason to install prophylactic antibiotic treatment. Despite such prophylaxis, further recurrences are occasionally encountered. OBJECTIVES To investigate recurrences of erysipelas during prophylactic antibiotic treatment and to delineate the reasons for such failure. METHODS Retrospective chart review of 117 adult patients with episodes of erysipelas known in our institution between 1990 and 2004. RESULTS Recurrent episodes of erysipelas, despite prophylactic treatment, were found in eight patients. Our analysis indicated noncompliance, incorrect selection and insufficient dosing of antibiotics, and causative pathogens other than streptococci as demonstrable causes of the recurrence of erysipelas. In three patients, a reason for failure could not be identified. CONCLUSIONS In a minority of cases, erysipelas recurs despite antibiotic prophylaxis. Based on these cases, we first recommend that all efforts are made to (re)confirm the diagnosis of erysipelas and search for the causative microorganism. Based on this information, the right antibiotic with adequate dosing and timing can be selected. The issue of compliance with the prophylactic treatment should be addressed and finally, the clinician should be aware that prophylaxis does not prevent erysipelas in all cases.
Collapse
Affiliation(s)
- J B Koster
- Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, and Nijmegen University Centre for Infectious Diseases, PO Box 9101, 6500 HB Nijmegen, the Netherlands
| | | | | |
Collapse
|
48
|
Petit A. [Acute red swollen leg]. Rev Prat 2006; 56:2303-9. [PMID: 17352331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Antoine Petit
- Service de dermatologie 1, Hôpital Saint-Louis, 75010 Paris.
| |
Collapse
|
49
|
Röllinghoff M, Delank KS, Haupt WF, Eysel P. [Erysipel at the lower leg combined with a peripheral peroneus nerve palsy--an unusual occurrence]. ACTA ACUST UNITED AC 2006; 144:639-42. [PMID: 17187341 DOI: 10.1055/s-2006-955187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We present the clinical case of a fifty-year-old man who presented two times with a foot elevator paresis and an erysipel first on the right and after two months on the left side. Afterwards, we carried out a thorough case history with the help of clinical, radiological and magnetic resonance imaging. Even so the clinical pathology of the foot elevator paresis could not be manifested. A compartment syndrome could be discounted. In the context of the second stay during a neurology examination on both legs electromyography was performed and the nerve speed was tested. A peripheral peroneus paresis of unknown level and of unknown aetiology was demonstrated. The erysipel regressed rapidly under intravenous ampicillin antibiotics while the peroneus paresis was unchanged. The patent was released with a peroneus splint on both sides. With this case report we would like to point out the causes of peripheral peroneus paresis with regard to an additional erysipel. This case report is discussed regarding the possible aetiopathology and the current literature.
Collapse
Affiliation(s)
- M Röllinghoff
- Universitätsklinikum zu Köln, Orthopädische Klinik, Germany.
| | | | | | | |
Collapse
|
50
|
Leclerc S, Teixeira A, Mahé E, Descamps V, Crickx B, Chosidow O. Recurrent Erysipelas: 47 Cases. Dermatology 2006; 214:52-7. [PMID: 17191048 DOI: 10.1159/000096913] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Accepted: 07/28/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recurrence is a common complication of erysipelas (cellulitis). OBJECTIVES Todescribe the characteristics of patients with recurrent erysipelas and thereby, identify potential risk factors and evaluate prophylaxis efficacy. METHODS Data were retrospectively recorded from the files of 47 patients admitted to hospital between 1995 and 2003 for erysipelas recurrence. Studied variables included: general condition, regional and local factors, e.g. broken cutaneous barrier. Patient characteristics were used to construct tree-based models according to the classification and regression tree methodology. RESULTS Our patients suffered a mean of 4.1 recurrences. Cutaneous barrier disruption was observed in 81%, mainly intertrigo (60%). Antibiotic prophylaxis was taken by 68% of the patients for 30.6 months. After 1 and 2 years, 84 and 72% of the patients, respectively, were recurrence-free. CONCLUSION Our results showed that erysipelas recurrence has the same risk factors as single episodes and underlines the potential benefit of oral or parenteral antibiotic prophylaxis to prevent recurrences.
Collapse
Affiliation(s)
- S Leclerc
- Department of Internal Medicine, Hôpital de la Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie-Paris 6, Paris, France
| | | | | | | | | | | |
Collapse
|