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

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.