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At least 145 records · Page 8Linked to original sources
PubMed2004

Intramuscular bipenicillin vs. intravenous penicillin in the treatment of erysipelas in adults: randomized controlled study.

The objective of the study was to evaluate the efficacy of intramuscular penicillin: mixture of benzyl penicillin and procain penicillin (2 MU x 2 times daily) and intravenous benzyl penicillin (4 MU x 6 times daily) in the treatment of hospitalized adult patients with erysipelas. A prospective randomized unicentric trial was conducted. In total, 112 patients entered the study; 57 in the intramuscular group and 55 patients in the intravenous group completed the trial. The failure rate was 14% for intramuscular group and 20% for the intravenous group (P = 0.40). Local complications such as of the leg abscesses were observed in the two groups (intravenous 9.1%, intramuscular 7%; P = 0477). Of the patients treated with intravenous benzyl penicillin, 25.5% presented complications related to the route (venitis). Intramuscular penicillin should be considered an effective and well-tolerated treatment of erysipelas in adult patients.

Adult↗
PubMed1998

Use of an enrichment broth cultivation-PCR combination assay for rapid diagnosis of swine erysipelas.

We have previously described the creation by Tn916 mutagenesis of avirulent transposition mutants from a highly virulent strain of Erysipelothrix rhusiopathiae, the causative agent of swine erysipelas. In this study, we cloned a 2.2-kb DNA fragment which flanked the Tn916 insertion in an avirulent mutant (strain 33H6) and evaluated the possibility that this region could be used for the specific detection of E. rhusiopathiae. According to the sequences of this region, oligonucleotide primers were designed to amplify a 937-bp fragment of the E. rhusiopathiae chromosome by PCR. The specificity of the PCR was investigated by analyzing 64 strains of Erysipelothrix species and 27 strains of other genera different from Erysipelothrix. A 937-bp DNA fragment could be amplified from all E. rhusiopathiae strains tested, and no amplification was observed by using DNAs from the other species tested. To make a rapid and definite diagnosis of swine erysipelas in slaughterhouses, we developed an enrichment broth cultivation-PCR combination assay, which used a commercially available DNA extraction kit, to identify E. rhusiopathiae in the specimens from swine with arthritis. After samples were enriched in selective broth culture, detection of E. rhusiopathiae was tested by either conventional methods or the PCR. Of 102 samples tested, 15 samples were positive by conventional methods and 12 of the 15 samples were positive by the PCR. The detection limit of the PCR was 10(3) CFU per reaction mixture for the PCR-positive samples. These results indicate that this PCR technique could be used as a first-line screening technique for the specific detection of E. rhusiopathiae in specimens.

Animals↗
PubMed2006

Does erysipelas-like rash after hip replacement exist?

BACKGROUND: Orthopaedic implants are known to rarely induce or exacerbate dermatitis in metal-allergic patients. In the late 1990s, hypersensitivity to prosthetic material has been suspected to induce recurrent aseptic localized cellulitis. Patients presented with recurrent eruption of the skin overlying the implant, associated with fever. An aseptic origin of this new syndrome was hypothesized as no evidence of microbial involvement could be found and because antibiotic treatment was apparently inefficient. OBSERVATIONS: We observed 4 similar cases. All patients recovered after suppression of factors predisposing to erysipelas (gluteal portal of entry, anti-inflammatory drugs) and appropriate antibiotic therapy. DISCUSSION: Our conviction is that these manifestations are authentic infectious cellulitis. Delayed thigh erysipelas after hip surgery is a distinctive form of cellulitis, characterized by its unusual topography, its rapid outcome and the possibility to be recurrent.

Aged↗
PubMed1999

[Comparative investigations of a combined vaccine against parvovirus and erysipelas and corresponding monovaccines in different vaccination schedules. 1: Field trial].

In a field trial, the development of antibodies of a combined vaccine against the porcine parvovirus (PPV) as well as against swine erysipelas was compared with corresponding mono vaccines. Furthermore, these vaccines were used in different vaccination schedules. The tests were carried out on 109 gilts in three closed farms. In all gilts, a basic immunization repeated twice was carried out at the age of six months and at intervals of three weeks. The revaccination was carried out four months after the basic immunization with half of the animals, and six months after the basic immunization with the remaining gilts. Between the combined vaccine and the mono vaccine no significant differences in the development of antibodies against PPV could be found according to different vaccination schedules. The gilts having been vaccinated with the mono vaccine and boostered six months later showed significantly higher antibody titers against Erysipelothrix rhusiopathiae. Between the remaining vaccination groups no significant difference in the development of the antibodies against swine erysipelas could be found. On only one farm, a continuous decrease of antibody titers against PPV in case of altogether 238 non-vaccinated piglets until the sixth month of life could be observed. On the two other farms, an increase of antibody titers against PPV could be found at different points of time, which indicates an infection of the piglets. Between the individual vaccination groups no significant antibody titers against PPV could be measured in milk tests. With regard to the number of piglets born alive per litter, the number of piglets born dead per litter and the number of mummies, a significant difference could neither be found between the vaccination groups 1-4.

Animals↗
PubMed1999

[Erysipelas of the skin in fattening swine: assessment from the view of meat hygiene].

Nine pigs with acute erysipelas in skin manifestation have been subjected in 1998 to a bacteriological examination. Eight animals proved to have Erysipelothrix rhusiopathiae in muscles and/or organs. In the part of the well-defined rhomboid, bluish-red skin lesions, histology showed a disseminated acute vasculitis and a perivascular suppurating dermatitis and panniculitis. The actually valid Swiss Meat Inspection Ordinance which in case of erysipelas in skin manifestation requires only the elimination of the skin and admits the consumption of the meat, is not warrantable from the point of view of meat hygiene.

Animals↗
PubMed2001

[Erysipelas. Clinicopathological classification and terminology].

Erysipelas and necrotizing fasciitis are the words used to qualify 2 well-defined aspects of acute microbial dermohypodermal infection. According to the literature a third word, "cellulitis" is used to describe a large variety of inflammatory conditions of soft tissues, either infectious or not. The authors who advocate using this word consider either that an infectious cellulitis is a clinical variant differing from erysipelas or fasciitis, or that it describes the whole spectrum of acute microbial infections of soft tissues, including these 2 entities. This term, whatever its meaning, has no anatomical or histopathological validation. It should be definitively deleted and replaced by "dermohypodermal infection".

Erysipelas↗
PubMed2001

[Should NSAID/corticoids be considered when treating erysipelas?].

Using non-steroidal anti-inflammatory drugs (NSAID) in association with a suitable antibiotherapy in the treatment of erysipelas, is still being largely discussed in medical publications. When compared to other fields of medicine, here their use might be justified by their ability to reduce local inflammation processes, to relieve patients more quickly, and to prevent potential sequels due to an inflammatory process. Numerous reports have suggested an association between the use of NSAID and the progression of an invasive streptococcal infection, particularly necrotizing fasciitis. The exact mechanism is still unclear. No controlled survey (NSAID versus placebo) checking the efficiency and the safety of these treatments is currently available. Only one comparative study showed a gain of one single day for prednisolone The prednisolone-treated patients had a shorter median length of hospital stay (5 days vs. 6) than the placebo-treated ones. The median treatment time with intravenous antibiotics, in the placebo group, was 1 day longer than in the prednisolone group. The occurrence of side effects was not higher in the prednisolone group. If this currently available data is not sufficient to establish a relationship between severe infectious complications and the use of NSAID, one should be cautious when using them to treat erysipelas, since their efficiency has not been positively proved.

Adrenal Cortex Hormones↗
PubMed2001

[Erysipelas: evolution under treatment, complications].

OBJECTIVE: The authors studied the evolution and the complications of lower limb erysipelas under antibiotherapy. METHOD: The following parameters were studied in literature over the last 20 years (keyword=erysipelas): percentage of favorable course, delay for cure, local or systemic complications, prognostic factors, and mortality. RESULTS: Data was only available in series of hospitalized patients. The lower limbs were the exclusive or the most frequently involved areas. Under systemic antibiotherapy, the overall efficacy rates reached 76-84 p. 100, with apyrexia within 24 to 48 h, and regression of local symptoms within 4 to 6 days. The median hospital stay was 10-13 days. A longer hospital stay was observed for: older patients, associated diseases, longer duration of illness prior to admission, and presence of a leg ulcer. Complications were observed: abscess or superficial necrosis (3-12 p. 100), deep thrombophlebitis in 1.4 p. 100 of retrospective studies vs. 2.6-15 p. 100 in prospective series. Mortality was low (0.5 p. 100) due to systemic complications more than to the severity of local symptoms. Relapse was frequent (15-25 p. 100). DISCUSSION: The unavailability of data concerning outpatients limits the formulation of valid conclusions. Nevertheless the medical course was favorable (80 p. 100) with apyrexia within 2 days, and absence of local symptoms within 4 to 6 days. Mortality or longer duration of hospital stay was linked to age or to associated diseases. The risk of deep thrombophlebitis was rare in absence of predisposing factors. Systematic prevention should be suggested and care given to local predisposing factors responsible for frequent recurrent forms.

Erysipelas↗
PubMed2001

[Primary and secondary prevention for erysipelas].

Erysipelas is a bacterial infection of the deepest skin layer. Predisposing factors are systemic and/or local. Main systemic factors are alcoholism, diabetes and immunodeficiency. The main local factors are an Athlete's foot (tineapedis), venous or lymphatic stasis, prosthetic surgery of the knee, and a past history of saphenous phlebectomy, lymphadenectomy, or irradiation. Such predisposing factors account for the predominance of erysipelas in the lower limbs and for the frequency of recurrence. The prevention of recurrence is stressed by all authors, and would associate correct treatment of the disease, treatment of venous and lymphatic stasis and/or wounds. A preventive antibiotic treatment should be proposed to patients with multiple predisposing factors and frequent recurrence, by using prolonged therapy with Macrolides or Penicillin. Primary prevention could concern local and/or systemic predisposing factors; however its efficacy and necessity has yet to be demonstrated. The usefulness of nosopharyngeal streptococcal carriage eradication and/or vaccination has not demonstrated either.

Erysipelas↗
PubMed2001

[Management of erysipelas].

The objective of this literature review was to evaluate the therapeutic management of erysipelas. We selected 74 publications, some of written a long time ago, and thus open to criticism regarding their methodology. However, no recent or better study was available on the subject. Penicillin G remains the therapeutic reference. The use of macrolides and stretogramins is an alternative after the exclusion of severe forms of erysipelas. The preventive treatment of thrombosis by heparin must be discussed taking into account risk factors. More studies are necessary to suggest a coprescription corticoid/NSAIDs and antibiotherapy. The best antibiotic prophylaxis after the initial treatment isabenzathine-penicillin injection every 15 days.

Adrenal Cortex Hormones↗
PubMed2002

Batch potency testing of inactivated erysipelas vaccines by ELISA--development, validation and implementation.

Inactivated erysipelas vaccines are widely used to protect pigs against erysipelas disease caused by the bacterium Erysipelothrix (E.) rhusiopathiae. Quality control tests for this vaccine are laid down in the European Pharmacopoeia (Ph.Eur.) Monograph No. 64. A laboratory animal model using a vaccination-challenge procedure is currently required as batch potency test. More than 10 years ago we initiated the first studies to develop an alternative ELISA potency model to replace this regulatory challenge test in mice. A short retrospective outline of the various steps from the development of the method until implementation into the regulatory requirements is described.

Animal Testing Alternatives↗
PubMed1992

[Deep venous thromboses in erysipelas of the leg. A prospective study of 40 cases].

The treatment of lover limb erysipelas rests on antibiotic therapy directed against streptococci, but the necessity of prescribing a concomitant anticoagulant treatment has not yet been established. The incidence of deep vein thrombosis in patients with erysipelas of the leg in unknown. In a prospective study of 40 patients presenting with this type of skin disease, we looked for deep vein thrombosis, using systematically pulsed Doppler vein exploration combined with ultrasonography and, if necessary, a second Doppler examination and a phlebography. Six cases of deep vein thrombosis were diagnosed. This complication was observed in 5 patients at high risk for deep venous thrombosis; it had never been foreseen at clinical examination.

Adult↗
PubMed1992

[The use of clinical, immunogenetic and immunological indices for predicting the development of the recurrent form of erysipelas of the lower limbs].

A consecutive alternative analysis has been carried out of clinical, immunogenetic and immunological indices in patients with primary erysipelas of the lower extremities with and no recurrences during the last 3-5 years. The authors compiled a special scale allowing precise and early prediction of unfavourable, recurrent course of primary erysipelas of the lower extremities.

Adult↗
PubMed2005

[Erysipelas].

Erysipelas is an acute dermo-hypodermal infection (non necrotizing) of bacterial origin, mainly group A beta-haemolytic streptococcus. The lower limbs are affected in more than 80% of the cases and the identified risk factors are disruption of cutaneous barrier, lymphoedema and obesity. Diagnosis is clinical and based upon the association of an acute inflammatory plaque with fever, lymphangitis, adenopathy and leukocytosis. Bacteriology is usually not helpful because of low sensitivity or delayed positivity. In the atypical forms erysipelas must be distinguished from necrotizing fasciitis and acute vein thrombosis. Penicillin remains the gold standard treatment, although new drugs, given their pharmacodynamic profile, may be used. Recurrence is the main complication, being crucial the correct treatment of the risk factors.

Anti-Bacterial Agents↗
PubMed2006

[Argon plasma flowing the complex treatment of different forms of erysipelas].

The results of complex treatment of 113 patients with different forms of erysipelas were analyzed. In 73 (64.6%) of them argon plasma using "Argon scalpel SP-CPT" in therapeutic regimen was applied as daily local exposure. In 40 (35,4%) patients with complicated form of erysipelas regimen "coagulation" was applied for additional sanitation of wound surface after surgical treatment of purulent focus. The results of treatment in the study group were better than in the control group. Argon plasma may be regarded as effective method of prophylaxis of necrotic and purulent complications particularly in patients with high risk of these complications.

Adult↗
PubMed1991

[The heparin and trental treatment of patients with the hemorrhagic form of erysipelas].

Activation of procoagulant hemostasis and signs of increased consumption of thrombocytes were indications for the treatment of patients with hemorrhagic erysipelas by means of heparine (60 patients) and trental (30 patients). Heparine was introduced subcutaneously as "minidoses" by means of electrophoresis into the inflammation focus. Heparine produced a positive effect on hemostasis and fibrinolysis, favoured rapid disappearance of the hemorrhagic syndrome, prevention of complications of erysipelas. Trental effected positively thrombocytic hemostasis, local manifestations of the hemorrhagic syndrome but did not prevent the development of thrombophlebitis as complication of the disease.

Adolescent↗
PubMed1991

[Effectiveness of bemitil in recurrent erysipelas].

The trial entered 66 patients with recurrent erysipelas treated conventionally with addition of either immunostimulator bemitil (0.25-0.5 g/day orally for 5-7 days) or placebo. The bemitil group was free of intoxication symptoms and local manifestations, discharged from hospital sooner than the controls. Therapeutic efficacy of bemitil is due to its promotion of mononuclear phagocytes function which acts as an essential mechanism of antibacterial defence activation in patients with recurrent erysipelas.

Adjuvants, Immunologic↗
PubMed1990

[2 cases of melanomatous erysipelas--differential diagnosis and terminology].

Erysipelas carcinomatosum can be differentiated on the one hand from other special forms of cutaneous metastasis, such as carcinoma teleangiectaticum, carcinoma en cuirasse or carcinoma eburné and on the other from secondary tumour-specific or non-tumour-specific erythematous lesions. Two cases of erysipelas melanomatosum and transitional forms of the different types of cutaneous metastasis will be discussed with special reference to melanoma.

Combined Modality Therapy↗