What is Erysipelas?

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Erysipelas is a rare form of bacterial infection that primarily affects the face or the legs. It is a variation of cellulitis (infection of the skin). However, where cellulitis can occur on any part of the body and can be caused by several different bacteria, erysipelas is usually only caused by the bacterium streptococcus pyogenes, and only occurs in the above-mentioned locations.

One form of erysipelas, called swine erysipelas, was a persistent issue for pig farmers prior to the invention of antibiotics. Pigs would routinely die and whole farms could suffer from the disease. What began as lesions, in this case, all over the body, would quickly progress to organ damage, and eventually cause death. Now pigs are routinely inoculated for the illness in the form of preventative doses of antibiotics in order to avoid contracting the disease.

Erysipelas in humans is still rare. However, it requires immediate treatment. Left untreated, it can injure the heart and the joints. If one looks at the lives of past interesting people or in family histories, one sees the deaths of many by erysipelas. Anyone living prior to the development of antibiotics would see the disease progress and particularly settle in the joints where it would cause a great deal of pain. Many in the Victorian Era became addicted to opium in an attempt to address the pain of the condition.

Today, erysipelas is almost always recognized. The rash on the face may follow a butterfly pattern, spreading over the nose and the cheeks. The symptoms begin quickly and the rash is raised and orange, or purple from small blood vessels bleeding into the skin. The pronounced swelling and color of the rash makes it difficult to confuse erysipelas with other forms of cellulitis.

The rash is painful and may be accompanied by chills and fever. Such a rash means seeing a doctor as soon as possible to begin treatment. Treatment in the early stages usually means a 2-week course of oral penicillin or a penicillin-derived antibiotic. If one is allergic to penicillin, some of the newer antibiotics can be used instead.

Erysipelas can spread quickly, particularly to the joints. When the rash on the face or legs is untreated, those with the infection may require lifelong daily doses of antibiotics to keep the infection in the joints to a minimum. Usually, however, the signs of the infection are so marked and painful, that people will seek treatment early.

Anyone may contract erysipelas, but it seems to be most predominant among the very young and the elderly. There are several predisposing factors for contracting erysipelas. Most often the bacteria enters a recent surgical wound, and such swelling around the wound usually signifies at least some form of cellulitis. Insect bites, cuts, and pimples can all expose one to the causal bacteria. On the face this bacteria is commonly found in the nose and is responsible for most erysipelas found on the face.

Some populations are more likely to get erysipelas. Anyone with an autoimmune disease like lupus or HIV is more at risk. Those who have poor blood perfusion through blocked veins, reduced heart function, or heart defects are as well more likely to contract the infection. Those who live in persistent unsanitary conditions, like the homeless seem more inclined to contract erysipelas. As well, alcoholism is a risk factor for contracting erysipelas and a host of other infections.

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Post 13

Can this lie dormant and resurface? I had it several years ago, and in that same area I experience some occasional itching and discomfort.

Post 12

My mother had Erysipelas as a young child in the early 1900's. She said they expected her to die. A doctor diagnosed her and lanced a swollen area behind her ear which then drained heavily.

He told my grandmother that the results of the sickness may be impaired memory or difficulty retaining facts. I can't find any information that indicates this as a prognosis. Could this have been something else?

Post 11

I'm a 42 year old male, and I've had this awful stuff twice on my face. The first time, I was told it was impetigo, and amoxicillin cleared it up after a month! A year later it was back, and after two visits to two different hospitals, and three visits to my family doctor, I was given "permission" to see a specialist and was diagnosed with erysipelas and prescribed clindamycin. The medication is working well to clear it up and the sweating and nausea are finally gone.

Anyone reading this should encourage everyone they know and care about to always always seek out medical help if they get any type of rash redness or swelling on their face or legs. This stuff is so painful and dangerous and can be treated quickly and easily if you get the right help. A good dermatologist is the key!

Post 10

I have had erysipelas twice on my face in three months. I'm not elderly. I do help with sheep occasionally but never pigs. I am disappointed that it has come back again so soon. It's pretty awful and I really hope that it won't come back again.

The last time I got it was after a viral infection so my immune system may have been low. The antibiotics do help but I have also had steroids to reduce the inflammation and take the heat from the skin.

Post 9

can you have erysipelas more than once in your life? because i know someone who had it two years in a row and he keeps on getting it.

Post 8

Thank you for the detailed posting on erysipelas. My great-grandmother died at Napa State Hospital, California from "erysipelas", November 1936. She was 47 years old. "General Paresis" is also noted on the death report. Her body was cremated and the bill was paid by her employer 'Twin Peaks Hotel', San Francisco. She was a housekeeper.

Her son was planning a trip to visit her in San Francisco when a telegram arrived announcing her death. Well, that's my family history story. Thank you for letting me share Rebecca's story. I'm sad that she died alone and in excruciating pain.

Post 7

I had erysipelas in my leg exactly eight years ago. It seems to be less rare in this country (Israel), perhaps due to the hot climate.

While the first symptoms of this systemic infection appeared in the evening (chills, fever, nausea) as well as the terrible pain shooting through my leg, and I started high dosage antibiotics the next morning.

Three days later I was taken to the hospital where I spent another nine (!) days, part of the time on IV antibiotics. The infection had started blistering and I had a textbook case of erysipelas bullous.

It took quite a while to fully heal (basically), and I was left with a permanent red discoloration of my bottom shin, for which I have been told there is nothing that can be done.

I am very careful now for any cuts or athlete's foot to prevent an entry point for the infection. Don't wish it on anyone!

Post 6

My great grandfather also died at a young age of erysipelas. He was an agricultural labourer and died at 50 in 1880 in Pembrokeshire. It makes me sad to think how he must have suffered.

Post 5

I had this infection a few years ago, felt very unwell and rash spread quickly, three visits, first visit to hospital i was sent home and told to take paracetamol! but went to another hospital and they sent me to a skin specialist straight away who immediately diagnosed Erisypelas and treatment cleared it in a few days.

Post 4

It appears that the spelling of erysipilis is more common in England, and that it was commonly use in America at least until the early 20th century. It's

listed on numerous death records. But more modernly, it seems that erysipelas is the proper spelling.

Post 3

I think this infection is sometimes misspelled as erysipilis but I believe the proper spelling is erysipelas. I believe erysipelas is also sometimes referred to as Saint Anthony's fire. While infections to the face used to be the most common form of erysipelas, leg infections seem to predominate.

Post 2

Thanks so much for posting information on erysipilis. My g-grandfather died about 1888, in his forties. He had Erysipilis and suffered greatly. He had no idea how to stop the pain. A friend told him to make a "tea" out of lead shot and drink it! My g-grandfather did, and died, leaving a widow and small children. Guess he'd never heard of lead poisoning!

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