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Erysipelas is a skin infection that often follows strep throat.


Erysipelas, also called St. Anthony's fire, is caused by infection by Group A Streptococci. This same type of bacteria is responsible for such infections as strep throat, and infections of both surgical and other kinds of wounds in the skin. The infection occurs most often in young infants and the elderly.

Causes and symptoms

Erysipelas usually occurs rather abruptly. When the preceding infection was strep throat, the rash begins on the face. Occasionally, when the preceding infection was of a wound from an injury or operation, the rash will appear on an arm or leg.
Classically, the usual presentation is a bright-red, butterfly-shaped rash appearing across the bridge of the nose and the cheeks. It is hot to the touch, painful, shiny, and swollen, with clearly defined margins. The edges of the rash are a raised ridge, hard to the touch. There may be fluid-filled bumps scattered along the area. The rash spreads rapidly. Some patients have swelling of the eyelids, sometimes so severe that their eyes swell shut. The patient may have fever, chills, loss of energy, nausea and vomiting, and swollen, tender lymph nodes. In severe cases, walled-off areas of pus (abscesses) may develop beneath the skin. If left untreated, the streptococcal bacteria may begin circulating in the bloodstream (a condition called bacteremia). A patient may then develop an overwhelming, systemic infection called sepsis, with a high risk of death.


The rash of erysipelas is very characteristic, raising the practitioner's suspicion towards that diagnosis, especially when coupled with a history of recent strep infection. Attempts to culture (grow) the bacteria from a sample of the rash usually fail. When the bacteria are present in the blood, they may be grown in a laboratory, and identified under a microscope. Other laboratory tests involve reacting fluorescently-tagged antibodies with a sample of the patient's infected tissue. This type of test may be successful in positively identifying the streptococcal bacteria.


Penicillin is the drug of choice for treating erysipelas. It can usually be given by mouth, although in severe cases (or in cases of diagnosed bacteremia) it may be given through a needle placed in a vein (intravenously).
Even with antibiotic treatment, swelling may continue to spread. Other symptoms, such as fever, pain, and redness, usually decrease rapidly after penicillin is started. Cold packs and pain relievers may help decrease discomfort. Within about five to 10 days, the affected skin may begin drying up and flaking off.


With prompt treatment, the prognosis from erysipelas is excellent. Delay of treatment, however, increases the chance for bacteremia and the potential for death from overwhelming sepsis. This is particularly true of people with weakened immune systems (babies, the elderly, and people ill with other diseases, especially Acquired Immunodeficiency Syndrome, or AIDS). Frequently, an individual who has had erysipelas will have it occur again in the same location.


Prevention involves appropriate and complete treatment of streptococcal infections, including strep throat and wound infections.



Huerter, Christopher, et al. "Helpful Clues to Common Rashes." Patient Care 31, no. 8 (April 30, 1997): 9 +.

Key terms

Bacteremia — The presence of bacteria in the blood.
Streptococcus — A bacteria that causes erysipelas and strep throat, as well as other infections.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.


a febrile disease characterized by inflammation and redness of the skin and subcutaneous tissues, and due to Group A hemolytic streptococci; it is a form of cellulitis. The visible symptoms are round or oval patches on the skin that promptly enlarge and spread, becoming swollen, tender, and red. The affected skin is hot to the touch, and, occasionally, the adjacent skin blisters. Headache, vomiting, fever, and sometimes complete prostration can occur. Penicillin is the treatment of choice. Care must be taken to avoid spreading the disease to other areas of the body. Adj., adj erysipel´atous.
coast erysipelas a cutaneous manifestation of onchocerciasis seen in Central America, so called because of its resemblance to streptococcal erysipelas.
swine erysipelas a contagious and highly fatal disease of pigs, caused by Erysipelothrix rhusiopathiae.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


(er'i-sip'ĕ-lăs), Do not confuse this word with syphilis.
A specific, acute, superficial cutaneous cellulitis caused by β-hemolytic streptococci and characterized by hot, red, edematous, brawny, and sharply defined eruptions; usually accompanied by severe constitutional symptoms.
[G., fr. erythros, red + pella, skin]
Farlex Partner Medical Dictionary © Farlex 2012


(ĕr′ĭ-sĭp′ə-ləs, îr′-)
1. An acute bacterial infection of the skin and superficial lymphatic vessels, caused by streptococci and marked by localized inflammation and fever. Also called Saint Anthony's fire.
2. Infection of pigs, sheep, turkeys, or other animals with the bacterium Erysipelothrix rhusiopathiae, characterized by symptoms such as skin lesions and arthritis in mammals and septicemia in fowl. Humans who become infected with the bacterium from handling infected animals or animal products can develop erysipeloid.

er′y·si·pel′a·tous (-sĭ-pĕl′ə-təs) adj.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


Cellulitis, St Anthony's fire Infectious disease A superficial infection of the very old or very young, caused by β-hemolytic group A streptococci, group C streptococci, staphylococci, pneumococci Clinical Abrupt fever, malaise, vomiting, skin lesions with cellulitis, brawny induration, geographic discoloration, butterfly rash on face with minimal necrosis Lab ↑ ESR, ↑ WBCs Management Rest, hot packs, penicillin
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


A specific, acute, cutaneous inflammatory disease caused by β-hemolytic streptococci and characterized by hot, red, edematous, brawny, and sharply defined eruptions; usually accompanied by severe constitutional symptoms.
[G., fr. erythros, red + pella, skin]
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


(er?i-sip'e-las) [Gr. erythros, red, + pella, skin]
Enlarge picture
An infection of the skin (usually caused by group A streptococci) that is marked by a bright red, swollen, sharply defined rash (that stings or itches) on the face, scalp, arms, legs, or trunk. Systemic symptoms such as fevers, chills, sweats, or vomiting may occur; local tissue swelling and tenderness and blistering of the rash are common. A toxin released into the skin by Streptococcus pyogenes creates many of the signs and symptoms of the infection. Erysipelas occurs primarily in children, adults over age 60, people with immunocompromising illnesses, and individuals with prior lymphatic or venous obstruction or surgery. See: illustration; cellulitis


Oral or IV penicillins or erythromycin, or first-generation cephalosporins, vancomycin, or clindamycin may effectively eradicate the responsible bacteria. Analgesic and antipyretic drugs, such as acetaminophen or ibuprofen, cold packs and topical anesthetics, and elevation of the affected area provide comfort. Standard and barrier precautions are employed.


The prognosis is excellent with treatment. Without treatment, the infection may spread, or cause nephritis, abscesses, septicemia and death.

Patient care

Patients and family members are taught to use thorough handwashing before and after touching the affected area to prevent the spread of infection and how to safely clean or dispose of drainage-contaminated articles. The application of cool compresses and elevating the affected parts may reduce discomfort.

Medical Dictionary, © 2009 Farlex and Partners


A form of CELLULITIS from infection of the skin with streptococcal organisms. There are large, raised inflamed areas, high fever and severe illness from toxicity. The lymph nodes in the area are enlarged and tender. Treatment is with antibiotics.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


A specific, acute, cutaneous inflammatory disease caused by β-hemolytic streptococci and characterized by hot, red, edematous, brawny, and sharply defined eruptions.
[G., fr. erythros, red + pella, skin]
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
Regarding infectious diseases, only erysipelas and porcine dermatitis nephropathy syndrome were registered after macroscopic inspection.
The treatment of malignant inoperable tumors with the mixed toxins of erysipelas and bacillus prodigiosus.
However, there was no clear evidence of erysipelas, malignancy, filariasis, or donovanosis in the specimens.
The predisposing factors for erysipelas are disruption of the cutaneous barrier (dermatophytosis and chronic ulcers of the skin), venous insufficiency, obesity, diabetes mellitus, heart failure, and previous surgery (4-9).
Vaccination is done twice a year against erysipelas which has become endemic in the region; the vaccine used is given, according to the manufacturer's instructions, after a six-month period to growers and adults.
Edema of the limb favors erysipelas infections due to insufficient venous and lymphatic circulation, while erysipelas becomes an aggravating factor for lymphedema as a consequence of relapsing outbreaks [5].
Only after four years, she returned to the service to treat an outbreak of erysipelas of the legs and the accompanying worsening of the lower limb lymphedema.
The sick man was afflicted with the colic in connection with an attack of the erysipelas, and was on his side lying doubled up, with his knees under his chin, and the side of his swollen face upon the cold, damp deck....
The cause of death was given as erysipelas, a skin infection which can spread to other areas of body can occur through the bloodstream and today is treated with antibiotics.
There were more than 4.8m hospital admissions of adults with ABSSSI from 2005 through 2011, which included patients with cellulitis, erysipelas, wound infection, and major cutaneous abscess.
She had a recent history of erysipelas and was given nonsteroidal antiinflammatory drugs (NSAIDs) the day before her hospital admission.
Another common cause of potentially serious skin infections is Streptococcus pyogenes, which can cause erysipelas and cellulitis, which are characterized by the spread of the bacteria into the deep layers of the skin.