Erysipelas in Child
See also in: Cellulitis DDx,AnogenitalAlerts and Notices
Synopsis
Clinically, the infection presents as a strikingly red, well-demarcated plaque that is very tender. Burning paresthesias may be present. Cutaneous findings are usually preceded by abrupt onset of fever, chills, nausea, and malaise. In neonates and infants, poor feeding, irritability, and lethargy may accompany erysipelas. Lymphadenopathy is almost always present.
Trauma to the skin is thought to be an important factor in the development of erysipelas; therefore, a concomitant dermatophyte infection, surgical incision, ulceration, insect bite, or inflammatory skin condition may provide a portal of entry for bacteria. The nasopharynx is often the reservoir in cases of facial erysipelas. Additional predisposing factors for erysipelas include diabetes, immunocompromised states, and nephrotic syndrome.
Penile erysipelas responds to treatment with antibiotics but tends to recur, causing a progressive, chronic lymphedema with permanent swelling of the penis (elephantiasis). Elephantiasis may also develop in the lower extremities from recurring bouts of erysipelas.
If not treated promptly, complications in children include meningitis, septicemia, endocarditis, toxic shock, and necrotizing fasciitis.
Codes
ICD10CM:A46 – Erysipelas
SNOMEDCT:
44653001 – Erysipelas
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Differential Diagnosis & Pitfalls
- Cellulitis
- Periorbital / orbital cellulitis
- Toxic shock syndrome
- Nummular eczema
- Insect bite hypersensitivity
- Erythema migrans (see Lyme disease)
- Necrotizing fasciitis
- Acute contact dermatitis
- Drug reactions
- Deep venous thrombosis
- Abscess
- Neonatal omphalitis
- Juvenile gangrenous vasculitis of the scrotum
- Herpes zoster
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Last Reviewed:11/12/2020
Last Updated:12/07/2020
Last Updated:12/07/2020
Patient Information for Erysipelas in Child
Overview
Erysipelas is a skin infection caused by a bacteria called Streptococcus pyogenes. This bacteria may enter the body through an injury to the skin, such as a surgical incision, an insect bite, or another skin condition.The infection causes a rash that is bright red and may burn, itch, sting, and/or swell. It may blister.
Erysipelas most often occurs on the arms and legs, but is sometimes seen on the face. Men can get it on their genitals.
Who’s At Risk
Older adults and those who are immunocompromised are more likely to get erysipelas. This includes people with diabetes or kidney disease and people who abuse alcohol.Signs & Symptoms
The rash looks like bright red, smooth patches that are tender and warm to the touch. It may burn or tingle.Self-Care Guidelines
Rest and elevate the affected area, if possible. Cold washcloths on the rash may ease the burning and itching.When to Seek Medical Care
If the rash spreads to your eyelids or if you develop fever and chills, contact your doctor.Treatments
Your doctor might prescribe an antibiotic to kill the infection.Erysipelas in Child
See also in: Cellulitis DDx,Anogenital