Erysipelas is a rare form of bacterial infection that primarily affects the face or legs. It is a variation of cellulitis (skin infection). However, where cellulitis can occur anywhere on the body and can be caused by a number of different bacteria, erysipelas is usually only caused by the bacteria Streptococcus pyogenes, and only occurs in the locations listed above.
One form of erysipelas, called swine erysipelas, was a persistent problem for pig farmers before the invention of antibiotics. Pigs would routinely die and entire farms could suffer from the disease. What began as injuries, in this case to the entire body, would quickly progress to organ damage and eventually lead to death. Pigs are now routinely inoculated for the disease in the form of preventive doses of antibiotics to avoid contracting the disease.
Erysipelas in humans is still rare. However, it requires immediate treatment. If left untreated, it can damage the heart and joints. If one looks at the lives of interesting people in the past or in family histories, one sees the death of many from erysipelas. Anyone who lived before the development of antibiotics would see the disease progress and settle particularly in the joints, where it would cause a lot of pain. Many in the Victorian era became addicted to opium in an attempt to address the pain of the condition.
Today, erysipelas is almost always recognized. The rash on the face may follow a butterfly pattern, spreading over the nose and cheeks. Symptoms start quickly, and the rash is raised and turns orange or purple from small blood vessels bleeding into the skin. The pronounced swelling and color of the rash make it difficult to confuse erysipelas with other forms of cellulitis.
The rash is painful and may be accompanied by chills and fever. Such a rash means seeing a doctor as soon as possible to start treatment. Treatment in the early stages usually means a 2-week course of oral penicillin or a penicillin-derived antibiotic. If one is allergic to penicillin, some of the newer antibiotics can be used.
Erysipelas can spread rapidly, particularly to the joints. When the rash on the face or legs is not treated, people with the infection may require daily doses of antibiotics for life to keep joint infection to a minimum. Usually, however, the signs of the infection are so severe and painful that people will seek treatment early.
Anyone can get erysipelas, but it seems to be more prevalent among the very young and the elderly. There are several predisposing factors for contracting erysipelas. Most often, the bacteria enter a fresh surgical wound, and such swelling around the wound usually means at least some form of cellulitis. Insect bites, cuts, and pimples can expose one to the causative bacteria. On the face, this bacterium is commonly found in the nose and is responsible for most erysipelas found on the face.
Some populations are more likely to get erysipelas. Anyone with an autoimmune disease like lupus or HIV is at higher risk. Those who have poor blood perfusion through blocked veins, reduced heart function, or heart defects are also more likely to get the infection. Those who live in persistently unsanitary conditions, such as the homeless, seem more likely to get erysipelas. In addition, alcoholism is a risk factor for erysipelas and a number of other infections.