Last reviewed by Editorial Team on August 13th, 2018.
What is Erysipelas?
This is a rare form of bacterial infection that will primarily affect your legs or face. Erysipelas is a variation of cellulitis which is an infection of your skin. Although it is rare for a person to have this bacterial infection, at one time it was a persistent issue for farmers who raised pigs. The type that affected pigs was called “swine erysipelas” but since antibiotics were invented pigs are saved from this type of illness. Besides pigs benefiting from the invention of antibiotics people have also benefited from them because in the past people have died from erysipelas. This was because it could injure their heart and joints if not treated. Because of the pain it could cause in their joints many people during the Victorian Era became addicted to opium because in that time this was the medication that was used for pain.
Although anyone can get this bacterial infection it appears to be more prominent among the elderly and the very young. It also has three other names that it is called in other countries which are:
- Isnis sacer
- Holy fire
- St. Anthony’s fire
The general illness and symptoms will usually start within forty-eight hours after the initial infection. It is characterized by areas of:
Erysipelas can also be associated with some or all of the following symptoms:
- Blisters that are filled with pus
- Rash on your face, leg, and/or arm
- A shiny red rash
- The rash will be orange or purple in color because of the bleeding from the smallest vessels in your skin.
- The rash can be painful
- Under the sore or lesion your skin can be swollen painful, warm, hard, and extremely red
- The skin lesion have a border that is raised
- On the bridge of your nose as well as your cheeks you have sores or lesions
- Chills and shaking
- High fever
- Local lymphatic nodes that is tender and enlarged. Occasionally you may see a red streak that extends from these lymphatic nodes.
This is a rash that is recognizable because it will follow a butterfly outline that extends over your nose as well as your cheeks. It is also hard to confuse it with any form of cellulitis because of the color of the rash and the pronounced swelling.
As mentioned, it is a variation of cellulitis but the difference is that cellulitis can happen on any part of the body and can be caused by many different bacteria and with erysipelas it usually happens on your legs and face and is caused by one bacteria. That bacteria is called streptococcus pyogenes.
There are also some risk factors that make some people more susceptible to getting this rash than others which can include:
- Having the bacteria enter a new surgical wound
- Being bit by an insect
- Dog bites
- Anyone who has an autoimmune disease like HIV or Lupus
- Have heart defects, poor blood perfusion through veins that are blocked, or have reduced heart function
- Anyone who lives in unsanitary conditions like people who are homeless
- Skin ulcers or sores
- Strep bacteria in your nasal passages
- From an abrasion or small cut
When erysipelas is caught in its early stages the treatment would be two weeks of oral penicillin or penicillin-derivative antibiotic. There are newer antibiotics that can be used if you are allergic to penicillin. If you have a severe case you may need to have medication delivered through an IV line.
The symptoms will usually resolve in a couple of days but it may take weeks for your skin to return to normal condition. It is a bacterial infection that spreads fast and eventually will settle in your joints. If you do not have the rash on your face or legs treated, you will need to be treated with daily doses of antibiotics for the rest of your life in order to keep the infection in your joints to a minimum. If the bacteria get into your blood it can cause a condition that is called bacteremia. It can also spread to your bones and heart valves. Even after being treated successfully with antibiotics, in eighteen to thirty percent of the cases will have the bacterial infection return.