the Erysipel (Greek ερυσίπελας, erisípelas - red skin) is a bacterial infection of the upper Hautschichten and Lymphwege and shows up as sharply limited strong turning red. The Erysipel proceeds from small skin injuries and steps usually in the face, at arms or legs andmore rarely at the navel up. Other names for the Erysipel are Wundrose, red run and St.Anthonys fie
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causal are an acute Infection of the skin by β-hämolysierende Streptokokken of the group of A (Streptococcus of pyogenes). The entrance gate is frequently an epithelium defective - a wound, a Rhagade or a foot mushroom. In some cases such a defect can be looked for also in vain.
Patient with water storages in the fabric (so-called. Edemas) are more strongly endangered to get sick with a Erysipel in particular with before-existing lymphatic vessel damage. Reason for this is that the Lymphbahnen causes an evacuation of penetrated bacteria into the lymph nodes, there the bacteria by defense cells is then killed. With the lymphatic vessel damage this transport functions only conditionally.
typical for the Erysipel are a high-red, gradated, flammenförmige and sharply limited skin turning red. The turned red skin first still lies in the level of the environment, swells later on and is over-warmed. The symptoms can of small red points without accompaniments up to high-feverful Infektwith vibration frost and heavy impairment are enough. In some fell form blisters, which in-bleed can (bullous Erysipel/hemorrhagic Erysipel).
after one incubation period of 2 to 5 days begins the Erysipel mostly pötzlich with fever and vibration frost. Only hours after show it thosetypical skin changes.
diagnosis and differential diagnosis
recognizing this illness prepared usually no difficulties and can be sometimes placed as view diagnosis. The diagnosis is thus usually placed “clinically” - do not exciter-oh-point is usually possible. Difficulties prepare Erysipele on before-damaged skin,z. B. with a postthrombotischen syndrome. Danger of mistake exists with a Stauungsdermatitis in such a way specified particularly in the range of the legs and/or. an acute Dermatitis within the face range. Perhaps similar bacterial illness of the skin and hypodermis a looking at the beginning, which have however a racing process,is the nekrotisierende Fasziitis.
patient with Erysipel are usually taken up stationarily to the hospital. Usually a high-dose intravenous antibiotic therapy is necessary, since the Erysipel shows an expressed inclination to Rezidiven. In the first place penicillin or Cephalosporine stands howCefazolin. The therapy when heavy illness (lowered general condition, high fever etc.) effected as intravenous continuousdrip infusion. The treatment of lighter forms can take place also with antibiotic tablets. Antibiotic resistances against penicillin nearly never represent a problem with the treatment of the illness. The acute treatment further refreshing becomeEnvelopes with water or disinfecting substances (z. B.Hydroxychinolon - solution) assigned. Desweitern must be treated the entrance gate of the bacteria (z. B. Foot mushroom), in order to avoid a Rezidiv.
Damages are to be feared only in extreme untreated cases with patients with operated Herzklappe. Risk patients should the family doctorvisit therefore promptly.
the Erysipel a spontaneous recovery tendency shows complications, without treatment however often arises to Rezidive , which can lead by sticking the Lymphbahnen together to Lymphabflussstörungen (secondary Lymphödem) of an arm or a leg. Further complications are the Thrombophlebitis, as well asthe Hirnvenenthrombose and Meningitis with the occurrence in the face by the entrance of the exciters into Kollateralvenen in the deep face region. A nekrotisierende Fasziitis can develop with a Erysipel at the Unterschenkel.
- bullous Erysipel - a process form, with usually to 2. or 3.Develop for day flabby blisters.
- hemorrhagic Erysipel - with a bleedings into the lesion
- of echymatöses Erysipel - with small-area a bleedings
- of gangränöses Erysipel - a Erysipel with skin necroses
- moving Erysipel - (Erysipela migrans) - a Erysipel, which spreads into the environment, during it itself inCenter of the lesion again regresses.
- phlegmonöses or abszedierendes Erysipel - a Erysipel, which progresses into the depth. The phlegmonöse red run is rare and required often a surgical intervention.
- smooth or flat Erysipel - (Erysipelas glabrum or Erysipelas laevigatum) - a Erysipel in the early stagewith a smooth and shining surface in the rest of skin level.
Web on the left of
- further information to the disease picture and illustrations - to web page of the University of Berne (infection physician Professor. A. You consider
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