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
- Bed rest
- Elevation of the affected part
- Venous compression is recommended during the acute phase and subsequent weeks to reduce the risk of lymphedema
- 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 to 20minutes
AND
Silver sulfadiazine cream (topical), 12 to 24 hourly
OR
Mupirocin (topical) 2% 12 hourly for 5 to 7days
OR
Fusidic Acid (topical) 2% 12 hourly for 6 to 7days
AND
Phenoxymethylpenicillin (PO):
- Adult 250-500mg:
- Child: 25mg/kg 6hourly for 5 to 7days
OR
Flucloxacillin amoxicillin (FDC) (PO):
- Adult 500mg:
- Child: 25 to 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.