infectious diseases
Erysipeloid
Symptoms and Signs of Erysipeloid
Within 1 week of injury, a characteristic raised, purplish red, nonvesiculated, indurated, slowly evolving localized cellulitic rash appears on the hand, accompanied by itching and burning. Local swelling, although sharply demarcated, may inhibit use of the hand, the usual site of infection. The lesion’s border may slowly extend outward, causing discomfort and disability that may persist for 3 weeks. Localized erysipeloid is usually self-limited. Regional lymphadenopathy occurs in about one third of cases. Erysipeloid rarely becomes generalized cutaneous disease, which is characterized by purple skin lesions that expand as the lesion’s center clears, plus bullous lesions at the primary or distant sites. Bacteremia is rare and is more often a primary infection than dissemination from cutaneous lesions. It may result in septic arthritis or infective endocarditis, even in people without known valvular heart disease. Endocarditis tends to involve the aortic valve, and the mortality rate and percentage of patients needing cardiac valve replacement are unusually high. Rarely, central nervous system, intra-abdominal, and bone infections occur. 