Erysipelas

What is Erysipelas?

Erysipelas is an infectious disease characterized by the appearance on the skin or mucous membranes of foci of clearly demarcated acute serous or serous-hemorrhagic inflammation, fever and symptoms of general intoxication. The disease is prone to recurrent course.

Brief historical information
Erysipelas has been known since ancient times. In the writings of ancient authors, it is described under the name erysipelas (Greek: erythros – red + lat. Pellis – leather). The work of Hippocrates, Celsius, Galen, Abu Ali Ibn Sina is devoted to the issues of the clinic, differential diagnosis and treatment of erysipelas. In the second half of the XIX century N.I. Pirogov and I. Zemmelweis described the outbreaks of erysipelas in surgical hospitals and maternity hospitals, considering the disease highly contagious. In 1882, I. Feleizen received for the first time a pure streptococcus culture from a patient with erysipelas. As a result of the subsequent study of the epidemiological features and pathogenetic mechanisms, the success of chemotherapy, erysipelas with sulfonamides and antibiotics, the concept of the disease has changed, it has been attributed to the category of sporadic low contagious infections. A great contribution to the study of the problems of erysipelas in the Soviet era was made by E.A. Halperin and V.L. Cherkasov.

Causes of Erysipelas

The causative agent is group A streptococcus (S. pyogenes), which has a complex set of antigens, toxins and enzymes.

Epidemiology
The reservoir and source of infection is a person with various forms of streptococcal infection (caused by Streptococcus group A) and a “healthy” carrier of Streptococcus group A.

The mechanism of transmission is aerosol, the main route of infection is airborne, but contact infection is also possible. Entrance gates are various injuries (injuries, diaper rash, cracks) of the skin or mucous membranes of the nose, genitals, etc. Streptococcus group A often colonizes the surface of the mucous membranes and skin of healthy individuals, so the risk of infection with erysipelas is great, especially with elementary untidiness.

Natural susceptibility of people. The occurrence of the disease is probably determined by a genetically determined individual predisposition. Among the diseased women prevail. In individuals with chronic tonsillitis and other streptococcal infections, erysipelas occurs 5-6 times more often. Local factors predisposing to the development of facial erysipelas are chronic diseases of the oral cavity, caries, and diseases of the upper respiratory tract. The erysipelas of the chest and limbs most often occurs in lymphedema, lymphovenous insufficiency, edema of various origins, mycosis of the feet, and trophic disorders. Post-traumatic and postoperative scars predispose to localization of the lesion in the place of its location. Increased susceptibility to the face can be caused by prolonged use of steroid hormones.

Major epidemiological signs. I give birth to the most common infections of a bacterial nature. Officially, the disease is not registered, therefore, information on the incidence is based on selective data.

Infection can develop both exogenously and endogenously. Face mucus can be the result of lymphogenous drift of the pathogen from the primary lesion in the tonsils or the introduction of streptococcus into the skin Despite the rather wide spread of the pathogen, the disease is observed only in the form of sporadic cases. Unlike other streptococcal infections, the erysipelas does not have pronounced autumn-winter seasonality. The greatest incidence observed in the second half of summer and early autumn. People of different professions suffer from erysipelas: builders, employees of “hot” workshops and people working in cold rooms often suffer; for workers of metallurgical and coke-chemical enterprises, streptococcal infection becomes an occupational disease.

It should be noted that if in 1972-1982. the clinical picture of erysipelas was distinguished by the prevalence of moderate and light forms, then in the next decade there was a significant increase in the proportion of severe forms of the disease with the development of infectious-toxic and hemorrhagic syndromes. Recently (1995-1999), light forms make up 1%, medium-heavy ones – 81.5%, severe ones – 17.5% of all cases. The proportion of patients with erysipelas with hemorrhagic syndrome reached 90.8%.