In erysipelas

In erysipelas, low-grade fever and flulike illness are common prior to development of the lesion. The lesion is fiery red, raised above the level of surrounding skin, and has well-defined borders. 

Dses.— As an adhesive to excoriations, ulcers, bums, wounds, Ac. likewise in erysipelas. 

Actions and Uses.—Internally —Antacid in indiges tion, chronic diarrhoea and dysentery antidote to oxalic and most other acids. Externally — Desiccant for absorbing irritating discharges for protecting wounds, bums, and scalds from the air also in erysipelas. 

Cellulitis and erysipelas are bacterial infections of the skin. Although separate entities, there is some clinical difficulty in distinguishing the two. 0 Cellulitis is a bacterial infection of the dermis and subcutaneous tissue, whereas erysipelas is a more superficial infection of the upper dermis and superficial lymphatics. Although both can occur on any part of the body, about 90% of infections involve the leg.8,9 Another 7.5% of cases involve the arm or face. Erysipelas is most common in the young and the elderly. Typically, both infections develop after a break in skin integrity, resulting from trauma, surgery, ulceration, burns, tinea infection, or other skin disorder. 

Etiologic microorganisms vary according to the area involved, host factors, and exposures. In otherwise healthy adults, S. aureus and GAS are the most common causative bacteria. GAS is the causative pathogen in approximatey 65% of erysipelas cases.9 0Persons who are immunocompromised, have vascular insufficiency, or use injection drugs are at risk for polymicrobial cellulitis.3... 

The manifestations of and diagnostic criteria for erysipelas and cellulitis are presented in Table 70-2. Once diagnosed, cellulitis is grouped into uncomplicated or complicated presentations depending on patient characteristics and severity of... 

The infected area is described as painful or tender. In the case of erysipelas, the patient may complain of "burning pain" at the lesion site. 

I Penicillin is the treatment of choice for erysipelas. In uncomplicated cases, a 5-day course is as effective as a 10-day course.3 Other agents that are acceptable for treatment include clindamycin, erythromycin, cephalexin, and dicloxacillin. 

Vulnerary. Elder is an effective remedy for relieving hemorrhoids when applied topically as a salve. Elder has been used to treat erysipelas, an acute inflammation caused by strep bacteria that erupts on the skin. Elder has also served humankind well in applications for bums, cuts and wounds. It can also be used as a sore throat gargle or for inflamed gums and mouth tissue. Parts used flowers, berries, leaves. 

Bacterial infections of the skin can be classified as primary or secondary (Table 47-1). Primary bacterial infections are usually caused by a single bacterial species and involve areas of generally healthy skin (e.g., impetigo, erysipelas). Secondary infections, however, develop in areas of previously damaged skin and are frequently polymicrobic. 

Mild to moderate cases of erysipelas in adults are treated with intramuscular procaine penidUin G or penicillin VK. For more serious infections, aqueous penicillin G, 2 million to 8 million units daily, should be administered IV. Penicillin-allergic patients can be treated with clindamycin or erythromycin. 

Other infectious diseases, such as pneumonia, typhoid fever, and erysipelas, may cause delirium, often associated with high fever. The temperature rise (fever) itself alters brain metabolism by affecting different enzyme systems differently. In addition toxic substances produced by infective agents may directly affect metabolic processes. 

Hypersensitivity to any component monotherapy in primary bacterial infections such as impetigo, paronychia, erysipelas, cellulitis, angular cheilitis, erythrasma (clobetasol), treatment of rosacea, perioral dermatitis, or acne use on the face, groin, or axilla (very high or high potency agents) ophthalmic use. 

Bacterial superficial skin infections including cellulitis and erysipelas, furunculosis and impetigo usually have a benign course. Infections of the subcutis often lead to necrosis of soft tissue. These infections are described in section 16 (surgical infections). Arthritis involves infection of the synovia and... 

Breaches in the integrity of the skin (eczema, trauma or burns) are predisposing factors for infection. Lymphoedema represents a risk for erysipelas. Open complicated fractures are often complicated by chronic osteomyelitis. Patients with diabetes mel-lims have more frequent as well as more severe infections of the skin, soft tissue and of bone. Sickle cell disease predisposes to osteomyelitis. 

Therapy should always be streamlined if and when a microbiological report becomes available. Erysipelas caused by streptococci can be treated by penicillin. In arthritis and osteomyelitis, culture of the joint fluid or of deep tissue is recommended before the start of treatment. 

It is used in tonsillitis, otitis media, erysipelas, prophylaxis of rheumatic fever and pneumococcal infections. 

Syringa dilatata Nakai S. oblata Lindley S. oblata Lindley var. alba Hort. ex Rehd. S. reticulata (Blume) Hara var. mandshurica (Maxim.) Hara S. suspensa Thunb. (Syn. Forsythia suspensa) S. vulgaris L. Lian Qiao (bark, fruit) Syringin, 3,4-dihydroxyphenethyl alcohol, saponons, phillyrin.49 Antipyretic, antiphlogistic in infectious fevers, suppurative inflammation, phlegmon, variola, erysipelas, measles. 

N.A. No information is available in the literature. For meningitis, encephalitis, mumps, influenza, erysipelas, heat rash, sore throat.335... 

Syringa suspensa Thunb. S. vulgaris L. China Syringin, 3,4-dihydroxyphenethyl alcohol, saponons, phillyrin.49 Antipyretic, antiphlogistic in infectious fevers, suppurative inflammation, phlegmon, variola, erysipelas, measles. 

---