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Erysipelas vs. Cellulitis
Erysipelas is a bacterial infection of the skin's upper layers and lymphatic vessels. It is a more superficial infection than cellulitis and is often called "St. Anthony's Fire" due to its fiery, red appearance. Prompt medical attention is necessary to treat the infection and prevent complications.
Symptoms/Signs of Erysipelas typically have a rapid onset and may include:
- A distinctive rash: A bright red, swollen, painful, and shiny patch of skin with a sharply defined, raised border. The rash may have a texture similar to an orange peel.
- Systemic symptoms: Many people experience fever, chills, fatigue, and headaches.
- Other features: The affected area is warm and tender to the touch. Blisters and sores can also form. In some cases, red streaks may extend from the rash toward the lymph nodes.
Causes and risk factors
Erysipelas is most often caused by Streptococcus pyogenes (group A strep) bacteria, which enter the body through a break in the skin.
Risk factors for infection include:
- A break in the skin from a cut, abrasion, insect bite, or surgical wound.
- Chronic skin conditions like eczema or athlete's foot.
- Impaired lymphatic drainage, which can be caused by obesity or surgery, such as a mastectomy.
- A compromised immune system.
- Older age and infancy.
Diagnosis and treatment
Diagnosis is typically based on a physical exam and the characteristic appearance of the rash.
Treatments include:
- Antibiotics: Oral antibiotics, such as penicillin, can treat mild cases. For severe infections, antibiotics are administered intravenously in a hospital.
- Symptom management: Cold packs and pain relievers can help reduce discomfort. Elevating an affected limb can help with swelling.
Erysipelas vs. Cellulitis
While Erysipelas is a form of Cellulitis, there are key distinctions:
| Feature | Erysipelas | Cellulitis |
|---|---|---|
| Affected skin layer | Superficial (upper dermis). | Deeper tissues (subcutaneous fat). |
| Borders | Sharply defined and raised. | Indistinct and not raised. |
| Appearance | Bright red and shiny. | Can be less intensely red or purple. |
| Onset | Acute and rapid. | Generally develops more slowly. |
Potential complications
Left untreated, the infection can spread through the bloodstream and lead to serious complications, though most cases have a good prognosis with proper treatment.
Possible complications include:
- Sepsis
- Infective endocarditis
- Meningitis
- Recurrent infections, which can cause long-term lymphatic damage and chronic swelling
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