infectious diseases
Erysipeloid
Key Points
Erysipeloid typically results from a penetrating wound in people who handle edible or nonedible animal matter (eg, in a slaughterhouse) or who work with fish or shellfish. Within 1 week after the injury, a raised, purplish red, nonvesiculated, indurated, maculopapular rash appears, accompanied by itching and burning; about one third of patients have regional lymphadenopathy. Bacteremia is rare but may result in septic arthritis or infective endocarditis. Diagnose by culturing a full-thickness biopsy specimen or an exudate obtained by abrading a florid papule. If endocarditis due toE. rhusiopathiaeis suspected, rapid identification of the pathogen is critical because treatment is often different from the usual empiric treatment of gram-positive bacillary endocarditis;E. rhusiopathiaeis resistant tovancomycin, which is typically used to treat gram-positive bacillary endocarditis. Treat with antibiotics (eg, penicillin,ciprofloxacin) based on extent and location of infection. 