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Erysipelas

J H Haynes, J C Martin, F T Kurzweg

    American Family Physician
    |May 1, 1983
    PubMed

    Insights

    Erysipelas, a painful skin infection, commonly caused by Group A streptococci, can present without easily culturable bacteria. This case highlights a severe infection in a leg with prior vein harvesting for heart surgery.

    Area of Science:

    • Dermatology
    • Infectious Diseases
    • Vascular Surgery

    Background:

    • Erysipelas is a superficial cellulitis impacting skin and subcutaneous layers, often involving lymphatics.
    • Group A streptococci are the typical causative agents of this infection.

    Observation:

    • The causative organisms are not consistently identified in the characteristic rash of erysipelas.
    • A severe case of erysipelas occurred in a patient's left leg.

    Findings:

    • The patient had undergone vein harvesting from the affected leg four months prior for coronary artery bypass surgery.
    • The infection presented as a fiery red, edematous, and vesicular rash, indicating a fulminating condition.

    Implications:

    • This case underscores the potential for severe erysipelas in compromised limbs, even after significant time has passed since vascular procedures.
    • Highlights the importance of considering erysipelas in post-surgical patients with leg infections, irrespective of bacterial culturability.

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