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Erysipelas


Erysipelas is a common acute infectious disease with the phenomena of limited skin inflammation. Has a tendency to relapse.
Cause. In most cases, the pathogens are streptococci.
The source of infection is a sick person or a carrier of streptococcus.
Infection occurs when the streptococcus enters the skin with its preliminary microtraumatization and contamination - abrasion, abrasion, scratching, scratching, cracks, fungal lesions and even imperceptible breaches of its integrity. Often the exciter is transferred to the patient himself if he has another streptococcal disease. The disease occurs only when the resistance of the organism decreases under the influence of some unfavorable factors. Rogers are more often sick with women and elderly people.
Relapses of erysipelas usually occur in the same place. This is due to the presence here of chronic lymphatic outflow and the development in this area of ​​the skin of hypersensitivity to the pathogen or keeping it there in a "dormant" state. Recurrence of erysipelas is promoted by insufficient and incorrect treatment. Relapse, as a rule, occurs without previous trauma.
Immunity after mug does not arise. On the contrary, there may be increased sensitivity to streptococcus.
The process of development of the disease. After the introduction of streptococci into the skin, they multiply there with the release of poisonous products that cause intoxication and inflammation, often with damage to the vessels of the skin, which is manifested by pinpoint hemorrhages. Sometimes in the skin cavities are formed, filled with clear liquid or pus. Occasional necrosis of certain areas of the skin.
With a relapsing erysipelas, sooner or later the skin defect is replaced by a scar tissue, as a result of which lymph circulation is disturbed, which can lead to the development of elephantiasis.
Signs. The incubation period lasts from a few hours to 2-3 days.
Usually the mug begins sharply. The temperature of the body with chills rises rapidly to 39-40 ° C, weakness, weakness, pain in the muscles of the trunk and extremities, headache, nausea, and sometimes vomiting.
In the area of ​​the affected area of ​​the skin at first appear only an itch, a burning sensation. After 10-24 hours from the onset of the disease, pain, a feeling of heat, then a red spot, which rapidly, within a few hours, grows in size by peripheral growth. The affected area of ​​the skin is pink or bright red, has clear, but irregular edges in the form of "flame tongues," slightly elevating. If the eyelids, lips, genitals, fingers are affected, pronounced edema is observed. The skin in the area of ​​inflammation is strained, hot and sharply painful when touched.
Erysipelas usually occur on the face, near the edges of the nasal aperture, nasolabial folds, the back of the nose, on one or both cheeks in the form of a butterfly, at the corners of the mouth and the external auditory canal, as well as on the scalp. It is observed less often on legs, even more rarely in other areas.
Perhaps the formation of small and large bubbles, filled with clear, purulent or bloody contents. Spot hemorrhages can also occur against the background of a red spot. Usually, the bubbles burst, the leaking liquid is poured into the crusts.
The duration of the febrile period varies from 2 to 10 days and depends on the start of treatment and the severity of the disease. Skin lesions persist for 5-15 days.
Relapses of erysipelas can occur in the period from several days to 2 years after the previous disease.
With frequent recurrences of erysipelas, fever is small for 1-2 days, the patient's state of health remains satisfactory, skin lesions in the form of separate soft spots without swelling.
Recognition of the disease. Acute onset of the disease with fever and characteristic skin damage.
Treatment. Patients with erysipelas are insignificant.
They need antibacterial treatment. The most effective antibiotic is benzylpenicillin, administered intramuscularly every 4 hours for 5-7 days. Long-acting penicillin preparations - bicillin, retarpen, extensillin, may be used, preferably in the form of intramuscular injection at the end of treatment with benzylpenicillin. There are preparations of penicillin intended for ingestion - ospen-750 syrup - taken at 5 ml (750 thousand units) 4 times a day for 1-1.5 h before meals. When allergic to penicillin, apply erythromycin 0.5 g 4 times a day for 1 hour before meals for 7-10 days (up to 2-3 days after the disappearance of inflammatory skin phenomena). In case of a face mug, other antibacterial drugs harmful to streptococcus may be used, but do not use sufanilamides and tetracycline, since streptococci are not sensitive to them.
In the feverish period, a plentiful drink is recommended. Antipyretics (acetylsalicylic acid, amidopyrine) are shown at body temperature 39 о С and above.
In the acute period of the disease, and with leg injuries - during the entire period of the disease, bed rest is recommended. At this time, the reception of multivitamins for 2 tablets 3 times a day is shown.
Local procedures in case of erysipelas are not recommended.
In case of severe disease, presence of concomitant diseases (diabetes mellitus, etc.), old age, lack of necessary home conditions for treatment, frequent relapses of the disease, hospitalization is indicated.
Examination. The patients are under medical supervision for 3 months, with a recurrent erysipelas - 2 years.
Prevention of disease. Compliance with the rules of personal hygiene, treatment of fungal diseases of the skin.
With recurrent erysipelas, a monthly introduction of prolonged penicillin preparations - bicillin, retarpen, extensillin - is indicated. The timing and duration of administration of drugs depend on seasonality and the frequency of relapse. This question is decided by the patient who watches the patient.