Erysipelas and Cellulitis
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Erysipelas is an acute superficial spreading infection commonly caused by Streptococci without pus formation. Could also be due to Gram negative bacilli.
Clinical presentation
A prodrome of fever, chills, and malaise
- Locally, a large erythematous, swelling, well-demarcated, and usually raised lesion
- Regional adenopathy is frequent
- Superficial blistering secondary to edema
- Superficial hemorrhage, may be sometimes be observed
Non-pharmacological Treatment
- Bed rest
- Elevation of the affected part
- Venous compression is recommended during the acute phase and subsequent weeks to reduce the risk of lymphedema
- Prophylaxis of deep venous thrombosis (DVT) should be considered depending on presence of other risk factors
Pharmacological Treatment
A: Weak potassium permanganate soaks, 1:40000 (0.025%) solution 12hourly for 3–4days, with each session lasting for 15–20minutes
AND
A: silver sulfadiazine cream (topical) 12hourly 24hourly
OR
C: mupirocin (topical) 2% 12hourly for 5–7days
OR
C: fusidic acid (topical) 2% 12hourly for 5–7days
AND
A: phenoxymethylpenicillin (PO): Adult 250–500mg; paediatric 25mg/kg 6hourly for 5–7days
OR
C: flucloxacillin + amoxicillin (FDC) (PO): Adult 500mg; paediatric 25–50mg/kg 6hourly for 5–7days
AND
A: ibuprofen 400mg (OP) 6hourly for 5days
Referral: Refer if there are local or general signs of severity of developing necrotizing fasciitis