Erysipelas is a rare form of bacterial infection that primarily affects the face or the legs. It is a variation of cellulitis (infection of the skin). However, where cellulitis can occur on any part of the body and can be caused by several different bacteria, erysipelas is usually only caused by the bacterium streptococcus pyogenes, and only occurs in the above-mentioned locations.
One form of erysipelas, called swine erysipelas, was a persistent issue for pig farmers prior to the invention of antibiotics. Pigs would routinely die and whole farms could suffer from the disease. What began as lesions, in this case, all over the body, would quickly progress to organ damage, and eventually cause death. Now pigs are routinely inoculated for the illness in the form of preventative doses of antibiotics in order to avoid contracting the disease.
Erysipelas in humans is still rare. However, it requires immediate treatment. Left untreated, it can injure the heart and the joints. If one looks at the lives of past interesting people or in family histories, one sees the deaths of many by erysipelas. Anyone living prior to the development of antibiotics would see the disease progress and particularly settle in the joints where it would cause a great deal 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 the cheeks. The symptoms begin quickly and the rash is raised and orange, or purple from small blood vessels bleeding into the skin. The pronounced swelling and color of the rash makes 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 begin 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 instead.
Erysipelas can spread quickly, particularly to the joints. When the rash on the face or legs is untreated, those with the infection may require lifelong daily doses of antibiotics to keep the infection in the joints to a minimum. Usually, however, the signs of the infection are so marked and painful, that people will seek treatment early.
Anyone may contract erysipelas, but it seems to be most predominant among the very young and the elderly. There are several predisposing factors for contracting erysipelas. Most often the bacteria enters a recent surgical wound, and such swelling around the wound usually signifies at least some form of cellulitis. Insect bites, cuts, and pimples can all expose one to the causal bacteria. On the face this bacteria 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 more at risk. Those who have poor blood perfusion through blocked veins, reduced heart function, or heart defects are as well more likely to contract the infection. Those who live in persistent unsanitary conditions, like the homeless seem more inclined to contract erysipelas. As well, alcoholism is a risk factor for contracting erysipelas and a host of other infections.