Erysipelas, a large retrospective study of aetiology and clinical presentation

BMC Infect Dis. 2015 Sep 30:15:402. doi: 10.1186/s12879-015-1134-2.

Abstract

Background: Erysipelas is a common and severe infection where the aetiology and optimal management is not well-studied. Here, we investigate the clinical features, bacteriological aetiology, and treatment of erysipelas.

Methods: Episodes of erysipelas in a seven-years period in our institution were studied retrospectively using a pre-specified protocol and is presented with descriptive and comparative statistics.

Results: 1142 episodes of erysipelas were identified in 981 patients. Patients had a median age of 61 years, 59 % were male, a majority had underlying diseases or predisposing conditions, and the leg was most often affected. Wound cultures were taken in 343 episodes and 56 grew group A streptococci (GAS), 53 grew group G streptococci (GGS), 11 grew group C streptococci (GCS), and 153 grew Staphylococcus aureus. Blood cultures were drawn in 49 % of episodes and 50 cultures were positive with GGS as the most common finding (21 cultures) followed by GAS in 13, group B streptococci in 5, S. aureus in 4, and GCS in 3 cultures. In 45 % of episodes, patients received antibiotics with activity against S. aureus.

Conclusions: GGS is the most common streptococcus isolated in erysipelas and the role of S. aureus in erysipelas remains elusive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Erysipelas / drug therapy
  • Erysipelas / microbiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Staphylococcus aureus / isolation & purification*
  • Streptococcus / isolation & purification*
  • Streptococcus pyogenes / isolation & purification
  • Young Adult

Substances

  • Anti-Bacterial Agents