Erysipelas-like

Introduction

Introduction to erysipelas Errysinoid is an infectious skin disease caused by infection with erysipelothrixinsidiosa, also known as erysipelothrixrhusiopatiae. It is often associated with occupation and occurs mostly in the hands of fish. Dan toxic damage can be accompanied by systemic symptoms. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: joint pain, endocarditis

Cause

Etiology of erysipelas

(1) Causes of the disease

Erythromycin erythropolis is the pathogen of this disease. It belongs to the genus Phytophthora, which is a Gram-positive bacillus. It has a distribution of bacteria in the soil and fish, pigs, birds and animals, and intestines. Animals such as sheep can also be infected under natural conditions. They are engaged in the meat industry, fur industry, fishery and other personnel, veterinarians, cooks, etc., and can be exposed to infections through hand-cutting or minor injuries.

(two) pathogenesis

Human infection with this disease is mainly due to exposure to contaminated pork or fish. Therefore, the disease is related to occupation. It is easy to infringe on the slaughtering industry, meat industry, fur industry, fishery and other personnel, veterinarians, cooks, etc. In the case of genital wounds or minor bruises, family women may cause infections due to stab wounds or cuts by scalpels when washing fish, but there is also no history of obvious trauma, which is caused by simple contact.

Prevention

Arsenic prevention

1, taboo all hair, moisturizing food and alcohol, spicy things, drink plenty of water.

2. Strengthen personal protection and prevent trauma.

3, the daily diet is mainly light, such as beef, lamb and seafood and other hot foods and spicy food can not eat at the time of onset.

4, rest, do not be too tired. Excessive fatigue, energy consumption hurts the body's blood, and the body's resistance is reduced. Should work and rest, strengthen physical exercise, improve the body's disease resistance.

5. Smoking cessation and alcohol withdrawal during the onset of illness. To maintain good hygiene habits, to prevent contact infection, do not share sanitary ware with your family, wash your feet with warm water every day, and avoid hot feet with too hot water.

6, ultraviolet radiation. It is a good habit to develop a foot wash and keep your lower limbs clean and hygienic. You should be able to change your socks and socks. If you have the conditions, you can change your shoes and socks frequently.

7. After the systemic and local symptoms disappear, it is necessary to continue taking the drug for several days. It is not advisable to stop the drug too early to prevent recurrence.

8. After the disease is cured, it tends to have repeated recurrences in the primary site. The primary site should be protected to prevent accidental bruises, insects, mosquito bites or hard scratching.

Complication

Arsenic-like complications Complications, joint pain, endocarditis

Septicemia is associated with joint pain and endocarditis.

Symptom

Symptoms of erysipelas common symptoms severe pain, pruritus, septicemia, discoid erythema edema, (toe) swelling, erysipelas, poisonous appearance, low fever

The disease is more common in young adults, more men than women, the incubation period is about 1 to 5 days, the skin lesions are more common in the hands, clinically divided into three types:

Limited type

For the most common type, the damage is similar to erysipelas, limited to the fingers or hands and the back of the foot, mostly unilateral, with limited erythema or purple erythema, mild edema at the edges, blisters or bullae on the surface, obvious boundary, Can be extended to the periphery, the center self-healing, after a slow, no systemic symptoms, consciously local burning, itching or tingling, the course of disease is about 3 to 4 weeks, easy to relapse after the recovery, bacterial blood culture is negative.

2. Diffuse type

Rarely, it starts at the finger end and spreads along the arm to other parts. The rash is hidden when it occurs. It lasts for several days, accompanied by joint pain, fever and other symptoms. The affected finger can swollen like a sausage, the pain is severe and unbearable, and the movement is disordered. Bacterial blood culture was negative.

3. Septic type

Rare, the body appears discoid erythema or purple spot, accompanied by joint pain and endocarditis, systemic reaction is severe, showing a toxemia-like manifestation. If not actively treated, the patient will die about 3 months, and the bacterial blood culture is positive.

Examine

Ergotoxicity test

The septic type bacteria were positive for blood culture, the diffuse bacteria were negative for blood culture, and the limited bacteria were negative for blood culture.

There is obvious edema in the epidermis and dermal papilla. Inflammatory cells infiltrate around the dermis and subcutaneous tissue. The infiltration is mainly lymphocytes, neutrophils and plasma cells. It can be stained with Gram-Weigert in the deep dermis and around the blood vessels of the subcutaneous tissue. Check out the porcine bacillus.

Diagnosis

Diagnosis of erysipelas

diagnosis

The limited type is based on occupation, finger has a history of stab wounds and a slightly high and clear edge, central faded purple red patches, local swelling, limited mobility, etc., generally not difficult to diagnose, systemic except for the above typical rash, often accompanied There is low fever, the affected finger can be swollen, severe pain, dysfunction of the joints, and the diagnosis is not difficult. The type of sepsis is only based on occupation, clinical symptoms (general erythema in the whole body, severe systemic symptoms, joint pain, etc.) and A positive blood culture can confirm the diagnosis.

Differential diagnosis

1. The erysipelas lesions are sometimes similar, but the erysipelas is bright red spots, edema is obvious, the calf and face are good, the systemic symptoms are more obvious, the erysipelas lesions are mostly purple, which occurs in the fingers and the back of the feet. Light, with a history of occupational exposure.

2. Cellulitis is more common in the face and trunk. The skin lesions are diffuse redness and pain, accompanied by severe systemic symptoms such as high fever, chills, general malaise, and bacterial tests can be identified.

3. Polymorphous erythema has no history of trauma and occupational exposure. In addition to being applied to the finger, it can also be seen in other parts of the body.

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