Table of ContentsView AllTable of ContentsSymptoms of ErysipelasCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms of Erysipelas
Causes
Diagnosis
Treatment
Erysipelas is sometimes referred to as St. Anthony’s Fire because of the fiery appearance of the rash. Erysipelas was identified as far back as the 11th century, where it and a cluster of other diseases were collectively named after Saint Anthony, the patron saint of lost causes.
This photo contains content that some people may find graphic or disturbing.See PhotoDermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
The appearance of the rash is generally rapid and fast-spreading. The infection may extend beyond the superficial layers and cause the formation of tiny, fluid-filled blisters (vesicles) and pinpoint blood spots (petechiae). The lymph nodes nearest the infection may also become swollen, as can the skin overlying the lymph nodes.
Lymphedemais a common feature of erysipelas wherein the obstruction of the lymphatic system causes fluid to overload tissues, leading to swelling (edema) of a limb, neck, or face.
Complications
Erysipelas can cause tiny cracks in the skin’s barrier, allowing the bacteria to enter the bloodstream. In some cases, this can lead to a systemic bacterial infection known asbacteremia. If this happens, the infection can disseminate (spread) and begin to affect joints, bones, the heart, and the brain.
In rare cases, the dissemination of bacteria throughout the body can lead toendocarditis(a heart infection),septic arthritis,gangrene, or post-streptococcalglomerulonephritis(a kidney condition mainly affecting children).
How to Identify 19 Different Rashes
Erysipelas generally occurs when the bacterium enters a cut, abrasion, or other break in the skin and quickly multiplies and spreads via tiny lymph vessels just beneath the surface of the skin. In an attempt to neutralize the bacteria, the immune system will launch an inflammatory assault, causing local blood vessels to dilate and tissues to swell.
In some cases, the bacterium can penetrate uncompromised skin if there is pre-existing lymphedema (such as following a radical mastectomy where lymph nodes are removed). Without a lymphatic system to isolate disease-causing microorganisms, the skin is more vulnerable to local infections.
While lymphedema can increase the risk of erysipelas, erysipelas can alsocauselymphedema, increasing the risk of reinfection and recurrence.
Types of Bacterial Skin Infections and How to Treat Them
Risk Factors
Erysipelas most often affects elderly people and infants who have weaker immune systems and are less able to fight local infections. With that said, anyone can be affected, especially those with certain risk factors:
To make a definitive diagnosis of erysipelas, a healthcare provider often needs to exclude other possible causes such as:
Erysipelas vs. Cellulitis
Erysipelas affects the upper layers of the skin, whereas cellulitis affects deeper tissues. Because of this, erysipelas is more likely to form vesicles and release clear serous fluid, while cellulitis is more likely to formabscessesand release pus.
Cellulitis is typically slower to develop than erysipelas. With cellulitis, the affected skin is not nearly as red and rarely has well-defined borders. It is because erysipelas develops so quickly, overloading the skin will inflammation, that the fiery redness and demarcated rash occur.
What You Should Know About Cellulitis
The standard treatment for erysipelas is antibiotics. Penicillin is generally the first-line treatment option for streptococcal infections. Other antibiotics may be used if there is an allergy to penicillin.
Most cases can be treated with oral rather than intravenous (IV) antibiotics. Any pain, swelling, or discomfort can be treated with rest, a cold compress, and elevation of the affected limb. Nonsteroidal anti-inflammatory drugs like Advil (ibuprofen) or Aleve (naproxen) can be used to relieve pain and fever.
If the face is involved, chewing should be minimized to avoid pain in which case, a soft diet may be recommended during the healing phase.
In cases of sepsis (or when infections do not improve with oral antibiotics), IV antibiotics may be prescribed under hospitalization.
Even after the appropriate treatment, erysipelas can recur in 18% to 30% of cases, especially in those with a compromised immune system.
People with recurrent infections may need a prophylactic (preventive) dose of an antibiotic, taken daily, to prevent a recurrence.
How to Use Antibiotics Correctly
A Word From Verywell
Erysipelas is a fairly common skin infection that is easily treated in most cases and rarely leads to complications. Still, if you have symptoms of erysipelas, you should call your healthcare provider right away. Quick treatment prevents the worsening of your condition and helps ease discomfort.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Micheal Y, Shaukat E.Erysipelas. In: StatPearls.Sebastian A. (1999)A Dictionary of the History of Medicine. Nashville, TN: Parthenon Publishing Group Inc.Bläckberg A, Trell K, Rasmussen M.Erysipelas, a large retrospective study of aetiology and clinical presentation.BMC Infect Dis. 2015;15:402. doi:10.1186/s12879-015-1134-2Stevens DL, Bryant AE.Impetigo, erysipelas and cellulitis. In: Streptococcus pyogenes: Basic Biology to Clinical Manifestations.Matijasevic M, Dekic NA, Kolarevic D, et al.Erysipelas in breast cancer patients after the radical mastectomy.Cent Eur J Med.2012;7:149. doi:10.2478/s11536-011-0127-9Maxwell-Scott H, Kandil H.Diagnosis and management of cellulitis and erysipelas.Br J Hosp Med (Lond).2015 Aug;76(8):C114-7. doi:10.12968/hmed.2015.76.8.C114Brindle R, Williams OM, Barton E, et al.Assessment of antibiotic treatment of cellulitis and erysipelas. A systematic review and meta-analysis.JAMA Dermatol.2019;155(9):1033-40. doi:10.1001/jamadermatol.2019.0884Kozłowska D, Myśliwiec H, Kiluk P, Baran A, Milewska AJ, Flisiak I.Clinical and epidemiological assessment of patients hospitalized for primary and recurrent erysipelas.Przegl Epidemiol.2016;70(4):575-584.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Micheal Y, Shaukat E.Erysipelas. In: StatPearls.Sebastian A. (1999)A Dictionary of the History of Medicine. Nashville, TN: Parthenon Publishing Group Inc.Bläckberg A, Trell K, Rasmussen M.Erysipelas, a large retrospective study of aetiology and clinical presentation.BMC Infect Dis. 2015;15:402. doi:10.1186/s12879-015-1134-2Stevens DL, Bryant AE.Impetigo, erysipelas and cellulitis. In: Streptococcus pyogenes: Basic Biology to Clinical Manifestations.Matijasevic M, Dekic NA, Kolarevic D, et al.Erysipelas in breast cancer patients after the radical mastectomy.Cent Eur J Med.2012;7:149. doi:10.2478/s11536-011-0127-9Maxwell-Scott H, Kandil H.Diagnosis and management of cellulitis and erysipelas.Br J Hosp Med (Lond).2015 Aug;76(8):C114-7. doi:10.12968/hmed.2015.76.8.C114Brindle R, Williams OM, Barton E, et al.Assessment of antibiotic treatment of cellulitis and erysipelas. A systematic review and meta-analysis.JAMA Dermatol.2019;155(9):1033-40. doi:10.1001/jamadermatol.2019.0884Kozłowska D, Myśliwiec H, Kiluk P, Baran A, Milewska AJ, Flisiak I.Clinical and epidemiological assessment of patients hospitalized for primary and recurrent erysipelas.Przegl Epidemiol.2016;70(4):575-584.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Micheal Y, Shaukat E.Erysipelas. In: StatPearls.Sebastian A. (1999)A Dictionary of the History of Medicine. Nashville, TN: Parthenon Publishing Group Inc.Bläckberg A, Trell K, Rasmussen M.Erysipelas, a large retrospective study of aetiology and clinical presentation.BMC Infect Dis. 2015;15:402. doi:10.1186/s12879-015-1134-2Stevens DL, Bryant AE.Impetigo, erysipelas and cellulitis. In: Streptococcus pyogenes: Basic Biology to Clinical Manifestations.Matijasevic M, Dekic NA, Kolarevic D, et al.Erysipelas in breast cancer patients after the radical mastectomy.Cent Eur J Med.2012;7:149. doi:10.2478/s11536-011-0127-9Maxwell-Scott H, Kandil H.Diagnosis and management of cellulitis and erysipelas.Br J Hosp Med (Lond).2015 Aug;76(8):C114-7. doi:10.12968/hmed.2015.76.8.C114Brindle R, Williams OM, Barton E, et al.Assessment of antibiotic treatment of cellulitis and erysipelas. A systematic review and meta-analysis.JAMA Dermatol.2019;155(9):1033-40. doi:10.1001/jamadermatol.2019.0884Kozłowska D, Myśliwiec H, Kiluk P, Baran A, Milewska AJ, Flisiak I.Clinical and epidemiological assessment of patients hospitalized for primary and recurrent erysipelas.Przegl Epidemiol.2016;70(4):575-584.
Micheal Y, Shaukat E.Erysipelas. In: StatPearls.
Sebastian A. (1999)A Dictionary of the History of Medicine. Nashville, TN: Parthenon Publishing Group Inc.
Bläckberg A, Trell K, Rasmussen M.Erysipelas, a large retrospective study of aetiology and clinical presentation.BMC Infect Dis. 2015;15:402. doi:10.1186/s12879-015-1134-2
Stevens DL, Bryant AE.Impetigo, erysipelas and cellulitis. In: Streptococcus pyogenes: Basic Biology to Clinical Manifestations.
Matijasevic M, Dekic NA, Kolarevic D, et al.Erysipelas in breast cancer patients after the radical mastectomy.Cent Eur J Med.2012;7:149. doi:10.2478/s11536-011-0127-9
Maxwell-Scott H, Kandil H.Diagnosis and management of cellulitis and erysipelas.Br J Hosp Med (Lond).2015 Aug;76(8):C114-7. doi:10.12968/hmed.2015.76.8.C114
Brindle R, Williams OM, Barton E, et al.Assessment of antibiotic treatment of cellulitis and erysipelas. A systematic review and meta-analysis.JAMA Dermatol.2019;155(9):1033-40. doi:10.1001/jamadermatol.2019.0884
Kozłowska D, Myśliwiec H, Kiluk P, Baran A, Milewska AJ, Flisiak I.Clinical and epidemiological assessment of patients hospitalized for primary and recurrent erysipelas.Przegl Epidemiol.2016;70(4):575-584.
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