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[Non-Necrotizing Acute Dermo-Hypodermal Infections: Erysipela and Infectious Cellulitis].

Maria Alexandra Rodrigues1, Mónica Caetano2, Isabel Amorim1

  • 1Serviço de Dermatovenereologia. Centro Hospitalar e Universitário do Porto. Porto. Portugal.

Acta Medica Portuguesa
|May 10, 2021
PubMed
Summary
This summary is machine-generated.

Non-necrotizing acute dermo-hypodermal infections like erysipelas and cellulitis are typically caused by streptococcus. Managing risk factors like lymphoedema and obesity is crucial to prevent recurrence.

Keywords:
Cellulitis/diagnosisCellulitis/prevention and controlCellulitis/therapyErysipelas/diagnosisErysipelas/prevention and controlErysipelas/therapy Soft Tissue Infections/diagnosisSoft Tissue Infections/therapy

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Microbiology

Background:

  • Non-necrotizing acute dermo-hypodermal infections, including erysipelas and infectious cellulitis, are common bacterial infections.
  • Group A β-haemolytic streptococcus is the primary causative agent.
  • Lower limb involvement exceeds 80%, with risk factors including disrupted skin barrier, lymphoedema, and obesity.

Purpose of the Study:

  • To outline the clinical presentation and diagnostic challenges of non-necrotizing acute dermo-hypodermal infections.
  • To differentiate typical presentations from critical conditions like necrotizing fasciitis.
  • To emphasize appropriate treatment and crucial preventive strategies against recurrence.

Main Methods:

  • Clinical diagnosis based on characteristic signs: acute inflammatory plaque, fever, lymphangitis, adenopathy, and leukocytosis.
  • Distinguishing erysipelas from necrotizing fasciitis and acute vein thrombosis in atypical cases.
  • Review of first-line antibiotic treatments (flucloxacillin, cefradine).

Main Results:

  • Diagnosis is primarily clinical, as bacteriology often yields low sensitivity or delayed results.
  • Typical presentation includes fever, localized inflammation, and systemic signs of infection.
  • Recurrence is a significant complication requiring management of underlying risk factors.

Conclusions:

  • Prompt clinical diagnosis is key for effective management of erysipelas and cellulitis.
  • Addressing risk factors such as lymphoedema and obesity is essential for preventing recurrent infections.
  • Appropriate antibiotic therapy and risk factor management improve patient outcomes.