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Erysipelas St. Anthony’s fire/ Ignis Sacer
Acute beta hemolytic group A Streptococcal infection Predisposing factors: Any break in the skin Involves superficial dermal lymphatics Local redness, heat, swelling, raised, indurated border Prodromal symptoms: Malaise, chills, high fever, headache, vomiting, and joint pains
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Erysipelas PMN lekocytosis: 20,000/cu. mm or more
Skin lesions may vary from transient hyperemia, followed by slight desquamation to intense inflammation with vesiculation and phlegmon Eruption begins at 1 point as an erythematous patch and spreads by peripheral extension
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Erysipelas Advancing edge Raised and sharply demarcated
Vesicles or bullae may contain seropurulent May result to gangrene Most frequently affected sites: Face and Neck Face: begins on the cheek near the nose or in front of the lobe of the ear and spreads toward the scalp Complications: Septicemia, Deep cellulitis
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Erysipelas
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Cellulitis Suppurative inflammation involving the subcutaneous tissue
Streptococcus pyogenes Children, Immunocompromised: Increased risk for severe complications Hematologic malignancy, DM, IV drug abuse, Cardiovascular disorders
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Onset: Mild local erythema and tenderness, malaise, and chilly sensations, or a sudden chill and fever Erythema rapidly becomes intense and spreads Infiltrated and pits on pressure
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Central part becomes nodular
Surmounted by a vesicle that ruptures and discharges pus and necrotic material Lymphangitis may spread to neighboring lymph glands Gangrene, metastatic abscess, grave sepsis (Rare)
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Cellulitis
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