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At least 937 records · Page 52Linked to original sources
PubMed1996

[Pristinamycin in the treatment of acute bacterial dermohypodermitis in adults. An open study of 42 patients].

INTRODUCTION: We recently demonstrated that oral roxithromycin is as effective as intravenous penicillin G in adults with erysipelas. We therefore evaluated the effectiveness of pristinamycin, an antibiotic which is very active on streptococci and Staphylococcus aureus, in non-necrotizing bacterial dermohypodermitis in adults. PATIENTS AND METHODS: This prospective open study was conducted in one center and included immunocompetent patients with bacterial dermophypodermitis without signs of toxicity or local manifestations suggesting necrotizing fasciitis. Bacteriology tests included direct immunofluorescence for streptococcus (groups A, C, G) on skin biopsies of the lesion before treatment. Patients were treated with pristinamycin (Pyostacine 500, 3 g/day until 10 days after apyrexia), and evaluated clinically on day 0, 2, 6, 8, and 15. Overall treatment effect was assessed on day 15. RESULTS: The study group included 42 adults (23 woman and 19 men; mean age 64 +/- 3.5 yr). In 39 cases (93%), the bacterial dermohypodermitis was localized on the lower limb. The inflammatory lesion was well delimited, a characteristic feature of erysipelas, in 32 cases (76%). Sample culture, direct immunofluorescence or serology findings demonstrated presence of streptococci in 33 cases (79%). A single treatment with pristinamycin was successful in 36 patients, giving an overall rate of 86%. Drainage of a localized abscess was successful in 5 of 6 patients after initial failure of antibiotic treatment. CONCLUSION: This prospective study demonstrated the effectiveness of pristinamycin in non-necrotizing bacterial dermohypodermitis in the adult, especially in erysipelas. Overall effectiveness was comparable with that reported for penicillin G or macrolides in erysipelas.

Adult↗
PubMed2006

Investigations of the vertical transmission of Erysipelothrix rhusiopathiae in laying hens.

Erysipelas was diagnosed in a layer breeder flock in Sweden in 2002. Although vertical transmission of Erysipelothrix rhusiopathiae has not been previously described in chickens, the potential of erysipelas infection to adversely affect hatching eggs was of concern. To clarify the possible impact of erysipelas on hatching eggs and their progeny, an experiment was done using 200 hatching eggs collected from the infected flock. The eggs were incubated for 21 days, and the egg shells, infertile eggs, dead-in-shell embryos, and a sample of day-old hatched chicks and blood samples from 5-day-old chicks were cultured for E. rhusiopathiae. In addition, after 28 days of grow-out, the male chickens were euthanatized and cultured for the bacterium, and the remaining female chickens were placed as a backyard flock and observed over a 4-mo period. Bacteriological test results of the above-mentioned samples were negative for E. rhusiopathiae. Mortality rates were not excessive, and no clinical symptoms of erysipelas were observed during the period of observation. The result of the investigation suggests that in layer breeder chickens, E. rhusiopathiae is not vertically or egg transmitted and that the disease outbreak in the parent stock had no adverse impact on the quality of hatching eggs in terms of increased embryo mortality.

Animals↗
PubMed2003

[Magnetic resonance relaxometry of serum in patients with different forms of cellulitis in the dynamics of the disease].

AIM: To study the time of nuclear magnetic resonance (NMR) of spin-lattice serum relaxation (T1) in the dynamics of an infectious process in patients with different forms of erysipelas. MATERIALS AND METHODS: 37 patients with different clinical forms of erysipelas were examined in the acute period of the disease and in the early period of convalescence. RESULTS: A statistically significant increase in T1 NMR was ascertained in patients with bullous hemorrhagic erysipelas as compared with those with erythematous form. CONCLUSION: Pronounced changes in the functional status of serum in patients with hemorrhagic forms of erysipelas are of great importance in the development of the local hemorrhagic syndrome.

Adolescent↗
PubMed1982

[Alteration of cartilage by microbial agents and granulocytes].

Severe polyarthritis was induced in 42 SPF piglets by subcutaneous and intraarticular infection in one joint of the bacterium Erysipelothrix rhusiopathiae (Serotype B, strain T 28), which in its chronic stage morphologically resembles human c.P. The light and electron microscopic examination of the articular cartilage and synovial membrane reveals a parallel evolution of hyaline cartilage degeneration, and activation and proliferation of synovial lining cells. The initial cartilage alteration with demasking of collagen fibrils and focal degeneration of chondrocytes in the erysipelas model is caused by direct action of the microbial agent, fibrin and few granulocytes Erysipelothrix bacteria and neutrophilic granulocytes are able to invade the superficial and intermediate cartilage layers. This model is not considered a suppurative infectious arthritis. In chronic villous erysipelas polyarthritis, which develops without the presence of neutrophils in the cartilage, the invasively growing synovial pannus dominates, which deeply destroys the pre-damaged cartilage, resulting in macroscopic focal or wide-spread cartilage erosion. We consider the poorly vascularized cartilage and the particular fibrosis suitable sites for the extremely long (up to three years) persistence of this microbial agent. The persistence of the agent is considered necessary for the persisting immunological reactions and the perpetuation of erysipelas polyarthritis. With longer duration (1-3 years) of experimental erysipelas polyarthritis the number of bacteriologically positive arthritic joint decreases. Microscopically, the causative bacteria may only sporadically identified.

Animals↗
PubMed2002

[Infectious complications of lymphedema].

Erysipelas and lymphangitis are frequent complications of lymphedemas (20 to 30%). The most important risk factor for erysipelas is lymphedema since this is a protein rich edema that contributes to the risk of infection. In case of lymphedema the treatment is the usual consensus treatment for erysipelas. A prophylactic treatment with penicillin is requested as soon as the first recurrence. This prophylactic treatment includes skin care, particularly treatment of injuries and intertrigos. Hyperplastic skin leads to maceration and then mycoses. Physiotherapy does not increase the risk for infection. Moreover an infection needs a complex decongestive physiotherapy which decreases risks of recurrence.

Antibiotic Prophylaxis↗
PubMed2001

[Severe Streptococcus pyogenes cutaneous infections].

Streptococcus pyogenes is the first bacteria encountered in severe cutaneous infections in children. They enclose erysipela (papillar derma concerned more than hypoderma, lymphatic involvement) and necrotising fasciitis NF (focus on fascia and muscles with extension to hypoderma and reticular derma; venous thrombosis; hypodermic and aponevrotic necrosis). A skin lesion is the entrance of infection: varicella lesions are a major factor of NF. In France, sporadic cases in children are observed. The annual incidence of S. pyogenes invasive diseases is 1/100,000 children under 5 years of age and 0.6/100,000 children under 15 years of age. In North America, resurgence has been notified during the past ten years with mortality and morbidity due to NF and toxic shock syndromes. Interaction between bacteria and host, natural reservoir, explains the physiopathology. During the past ten years, some serotypes have become more invasive and virulent. Any cutaneous lesion interrupt the dermal barrier. Bacterial wall, proteins M and adhesins permit colonisation. Four pyrogenic exotoxins are superantigens; some facilitate inflammation, tissular lesions and shock; other participate to bacterial extension. In young children, immune response is immature. Albeit causal link between non-steroids anti-inflammatory drugs and NF in varicella children was not clearly demonstrated, caution should be kept in mind. Diagnosis of erysipela is clinical: sudden appearance of an inflammatory zone, most often on legs, with high fever and pain; sometime peripheral surelevation, lymphangitis, adenopathia. Other aspects open discussion with NF. In NF are in favour, added to high fever, huge pain, erythema and oedema: rapid extension of lesions, cutaneous hypoesthesia appearance, gap between intense severe general status (toxic shock syndrome) and paucity of local signs. NF is a medico-surgical emergency. Early surgery with complete excision of necrotic tissues permit survival. Magnetic resonance is useful in subacute NF. Microbiological diagnosis is possible in 20 to 80% of cases, using combined methods. Blood cultures identify the bacteria in 5 to 20%, skin lesion samples in 30%. Local samples are less useful even with modern techniques. Therapeutic strategy depends on initial diagnosis. Intra-venous antibiotics are necessary: penicillin (G, A or M) is first line therapy. In erysipela, ten days allow a rapid cure without sequellae. In NF, antibiotics are associated with intensive care and surgery. A late diagnosis, a too late surgery explain 16 to 36% of deaths encountered.

Adolescent↗
PubMed2003

[Quantitative evaluation and qualitative results of surgical lymphovenous anastomosis in lower limb lymphedema].

PURPOSE: Treatment of lymphedema (LE) includes complex decongestive physiotherapy (manual lymphatic drainage, bandaging, exercises, skin care, elastic stockings). Surgical therapy is rarely useful. However, lymphovenous anastomosis (LVA) is the most used surgery in LE. We have assessed LVA in lower limb LE. METHODS: Thirteen patients (5 women, 8 men) with primary (n=10) or secondary LE (n=3) were included. Primary LE started at a mean âge (+/- SD) of 28.9 +/- 14.5 years. LE was located in left lower limb (n=7), right (n=4) or both (n=2). LVA was performed 7.1 +/- 4.9 years after the onset of LE by the same surgeon. Two to five lymphatic vessels were used for LVA. Assessment of LVA was based upon objective criteria (volumetry, erysipelas) and subjective criteria (global discomfort, heaviness, cutaneous tenderness, difficulties for doing significant effort or walking more than 1 km). Global assessement of LVA was collected for each patient. RESULTS: Before LVA, excess of volume (+/- SD) of LE was 1906 +/- 1277 ml or 28.5 +/- 18% in comparison with the controlateral limb. After LVA, excess of volume (+/- SD) remained stable with 1863 +/- 1468 ml or 24.4 +/- 18.9%. Volumetry was appreciated with a mean (+/- SD) follow-up of 52 +/- 3 months. Frequency of erysipelas was unchanged for the 6 patients with recurrent episodes. Only heaviness and cutaneous tenderness were significantly reduced after LVA. But global discomfort (+/- SD) decreased from 6.7 +/- 2.7 to 5 +/- 3.2 on visual analogic scale (NS). No differences were observed for significant effort or walking more than 1 km. Global assessment of LVA by the patient was very good (n=3), good (n=2), intermediate (n=5) and bad (n=3). CONCLUSION: LVA failed to improve the volume of lower limb LE and reduce the frequency of erysipelas. LVA improves few subjectives criteria but not global discomfort. Further studies are needed to evaluate LVA and to select patients to obtain best results.

Adolescent↗
PubMed1990

[The functional characteristics of the peripheral blood granulocytes in erysipelatous inflammation].

The receptors (FcR, C3R) and functional activity, determined by the nitroblue tetrazolium (NRT) test, of polymorphonuclear leukocytes (PML) of low and normal density were studied in erysipelas patients. The leukocytes were obtained by sedimentation on the 2-stage gradient of Ficoll-Verographin (1.077 and 1.119 g/cu cm). No statistically significant difference in the average group indices between "light" and "normal" PNL of erysipelas patients were detected. In comparison with donor PNL, higher expression of C3R, a high spontaneous NBT(+)-PNL level and poor response to stimulation with IgG in the NBT test were observed on granulocytes of the patients. The short-term treatment of the whole blood obtained from the patients with Streptococcus haemolyticus allergen led to a significant increase in the output of "light" PNL. As negative control, brucellin treatment was used, which produced no essential effect. The treatment of donor blood with the above-mentioned antigens did not significantly affect the density of PNL. These facts suggest that in erysipelas the presence of "light" PNL is linked not with the release of granulocytes from the marrow, but with the activation of leukocytes by the products of infective inflammation.

Erysipelas↗
PubMed1980

[Acute inflammatory exacerbations in lymphoedema (author's transl)].

The author describes changes in the skin, lesions in the lymph vessels and changes seen on lymphography. Amongst cutaneous lesions, necrosing lymphangitis or gangrenous lymphangitis are the most serious. In the calf, they develop after an extensive episode of acute erysipelas. In erysipelas, the most common cutaneous lesion, the course varies according to associated disturbances, lymphatic and lymphnode. Combining of these lesions results in the most severe forms of obliterating thrombolymphangitis, capable of simulating venous thromboses of the lower limbs. In abscesses associated wtih severe erysipelas, massive eosinophilia found. Endoarterial therapy is invariably selected. Lymphographic appearances are dependent upon the stage of progression of inflammation. Disappearance, increase in vascular parietal permeability, varicose and ectasic appearance of the lymphatics may be seen in the superficial and deep collecting vessels. During the chronic phase, lesions are more extensive and more obvious. They are characteristic of severe lymphatic stasis. Histopathological studies show lymphangitis and perilymphangitis characterized by polynuclear neutrophil infiltration during the acute phase. At a more advanced stage, obliterating endolymphangitis and acute thrombolymphangitis are followed at the chronic phase by fibrous lymphangitis.

Erysipelas↗
PubMed1998

Properties of repeat domain found in a novel protective antigen, SpaA, of Erysipelothrix rhusiopathiae.

Erysipelothrix rhusiopathiae is a small gram-positive rod bacterium that causes erysipelas in swine and a variety of diseases in other animals and humans. Although live-attenuated or bacterin vaccines are effective in protecting against erysipelas, the genetic construction of their active antigen has not been identified. To clarify the surface antigen(s) involved in protective and arthritic response, using monoclonal antibody I2A against the surface proteins of E. rhusiopathiae, we identified a protective antigen, which consists of 606 amino acids. Analysis of deletion derivatives of the gene, spaA(surface protective antigen), showed that the SpaA protein binds tightly to the bacterial cell surface via eight repeat units with a GW-module consisting of 20 amino acids at the C-terminus. Although DeltaSpaA lacking their repeat units lost its ability to induce protection against E. rhusiopathiae infection, intact SpaA protein showed the protection. We conclude that the presence of repeat units is essential both for the binding of SpaA to the bacterial cell surface and for protection. We believe that the repeat region at the C-terminus should be a candidate for a subunit vaccine against erysipelas.

Amino Acid Sequence↗
PubMed2000

Role of streptococcal infection in the acute pathology of lymphatic filariasis.

Growing evidence suggest that secondary bacterial, mainly streptococcal, infections contribute significantly to recurrent episodes of acute adenolymphangitis (ADL) of filarial origin. We examined the role of group A streptococci in the progression of lymphedema in Polynesian patients with filariasis-related ADL (22 cases) or chronic pathology (10 cases), or with erysipela (10 patients) and, as controls, in 20 healthy adults. Antistreptolysin O (ASLO) and anti-streptodornase B (ASDB) titers were systematically determined in parallel to parasitological and biochemical tests. ASLO and ASDB assays were positive in 100% of erysipela, 75% of filarial ADL as compared to 50% of chronic pathology and 39% of healthy controls. Interestingly, by opposition to ASLO titers which were not significantly different between the four groups, ASDB titers were higher in ADL (p = 0.019) and erysipela (p = 0.002) than in controls. These results support the hypothesis that recurrent streptococcal infections may have an important role in the pathogenesis of ADL in lymphatic filariasis.

Adult↗
PubMed2000

Phenotype-genotype correlation in 91 patients with familial Mediterranean fever reveals a high frequency of cutaneomucous features.

OBJECTIVES: To describe the clinical manifestations of familial Mediterranean fever (FMF) in 91 patients from 47 families and provide data from the genetic study. P:atients and methods. We conducted a retrospective chart review of 91 patients (including 83 children aged <15 yr) from 47 families through a questionnaire and a specific database. The genetic analysis included complete screening of known mutations of the MEFV gene on chromosome 16p13.3. A positive diagnosis required at least two mutations, one on each chromosome. RESULTS: Our panel included 52 females and 39 males, with a mean age of 7.27 yr. Of the 47 families, 31 were non-Ashkenazi Jews, 10 were Armenians and six were from other ethnic groups. Clinical features included fever (100%), peritonitis (86%), pleuritis (56%), arthritis (34%) and myalgias (27%). We observed a high rate of cutaneous manifestations (47%); erythema, oedema and recurrent oral ulcers were the most frequent. Phenotype-genotype correlations showed a significant association of M694V homozygosity with earlier age of onset (P: = 0.044), fever >39 degrees C (P: = 0. 002), pleural crisis (P: = 0.0044), splenomegaly (P: = 0.0005) and arthritis (P: = 0.001). Associations with mucocutaneous features were as follows: erysipelas-like erythema (P: = 0.012), oedema (P: = 0.61, not significant) and oral ulcers (P: = 0.45, not significant). CONCLUSION: New phenotype-genotype correlations emerged from our study: homozygosity for the M694V mutation was associated with intensity of fever, splenomegaly and with erysipelas-like erythema. Apart from erysipelas-like erythema, no significant association was found between other cutaneous features and the genotype.

Adolescent↗
PubMed1976

Purpura, pigmentation and yellow nails of the lower extremities in diabetics.

This article describes purpura and pigmentations of the lower extremities as well as yellow nails mainly in elderly diabetics but also in persons not known to have diabetes. When the latter were compared to controls, it appeared that their glucose tolerance was altered in a diabetic direction. Precipitating factors could generally be established for these lesions, predominantly cardiac decompensation with edema of the legs, and were more common in patients not known to have open diabetes than in patients with open diabetes. Petechiae were transformed into small, pigmented, non-atrophic spots. Petechiae and pigmented spots were often seen simultaneously. In a few patients small, pigmented, non-atrophic spots were seen as pronounced brown-black pigmentation of the lower legs and feet. In a number of patients with open diabetes or diabetic glucose tolerance, erysipelas with purpura within the area of erysipelas was observed on the lower extremities. Patients with no purpura within the area of erysipelas generally had normal glucose tolerance. The pathogenesis of these lesions is discussed. Atrophic circumscribed skin lesions (Melin), cutaneous erythema, with or without necrosis, purpura, pigmentation, red toes, as well as rubeosis plantarum, yellow nails and neuropathy are often seen simultaneously on the lower extremities of patients with open diabetes as well as of those without open diabetes but with diabetic glucose tolerance.

Aged↗
PubMed2006

A multiplex polymerase chain reaction for discriminating Erysipelothrix rhusiopathiae from Erysipelothrix tonsillarum.

Erysipelothrix rhusiopathiae is the causative agent of swine erysipelas, and it causes great economic losses in Japan and worldwide. In meat inspection, it is very important to distinguish E. rhusiopathiae from other bacteria showing similar clinical signs of disease or similar bacterial characteristics. To distinguish E. rhusiopathiae from Erysipelothrix tonsillarum, 2 polymerase chain reaction (PCR) systems were combined. The primer sets ERY-1F and ERY-2R were designed to amplify 2210 base pairs (bp) of nucleotide sequence specific for E. rhusiopathiae chromosomal DNA, and the primer sets MO101 and ERS-1R were designed to amplify 719 bp of nucleotide sequence including a highly conserved region of genus Erysipelothrix 16S rRNA. Two fragments were amplified when E. rhusiopathiae was used as the PCR template using the primer sets, whereas a single fragment was amplified when E. tonsillarum was used as the template. No fragments were amplified when nucleic acid from other bacteria that cause clinical signs similar to swine erysipelas were used as the template. Moreover, 5 specimens collected from postinspected swine carcasses were diagnosed as E. rhusiopathiae using the PCR described in this study, in agreement with results of microbiological tests for the genus Erysipelothrix, whereas negative samples were negative both in conventional bacterial tests and by PCR. The detection limit of multiplex PCR ranged from 10(2) to 10(4) colony forming units per reaction tube for positive samples. These results suggest that this method is useful for screening of swine erysipelas in meat inspection centers.

Animals↗
PubMed2001

Skin and soft tissue infection.

Abstract. Normal skin is heavily colonized by bacterial flora. The most common are the various nonpathogenic gram-positive bacteria such as Staphylococcus epidermidis (coagulase-negative). Skin and soft tissue infections are usually caused by Staphylococcus aureus (S. aureus) and Streptococcus pyogenes. This article discusses common and some not so common bacterial skin infections, including impetigo, folliculitis, furncles and carbuncles, cellulitis and erysipelas, gangrenous cellulitis, staphylococcal scalded skin syndrome and scarlet fever. Impetigo and ecthyma are common bacterial infections of the skin commonly caused by S. aureus and / or Group A streptoccus. In mild and localized impetigo topical antibiotics whereas in widespread or severe one and in ecthyma systemic antibiotics like, cloxacillin, erythromycin, azithromycin or cephalexin should be used. Folliculitis, furunculosis and carbuncle are folliculocentric infections caused by S. aureus involving the variable depth and extent of the follicle(s) and surrounding tissue. These conditions can be treated with topical or systemic antibiotics like cloxacillin, cephalexin, erythromycin, amoxicillin/clavulanic acid or vancomycin. Staphylococcal scalded skin syndrome is a toxin mediated exfoliative dermatosis caused by S. aureus of phase group II. Intravenous penicillinase-resistant anti-staphylococcal antibiotics like methicillin, cloxacillin, cephalosporin or erythromycin are required. Erysipelas and cellulitis are acute infections of dermal and subcutaneous tissues caused most frequently by Group A beta-hemolytic streptococci (erysipelas) or S. aureus requiring systemic antibiotics like oral or intravenous penicillin, erythromycin, cephalexin, cloxacillin, vacomycin, minocycline or ciprofloxacin depending upon the severity, suspected causative organism and culture/sensitivity results. Gangrenous cellulitis is characterized by infection with necrosis of skin and underlying subcutaneous tissue due to various pathogens occurring at different site. Ampicillin, gentamicin, and either metronidazole or clindamycin intravenously in standard doses are recommended for the treatment.

Cellulitis↗
PubMed1988

[Pneumatic compression of the arm in the treatment of postmastectomy edema].

The paper discusses the histories and results of examination of 200 cases of lymphedema of the upper extremity developing after radical surgery for breast cancer. Forty percent of patients had suffered erysipelas, its frequency being higher in a group of pronounced edema. The incidence of erysipelas dropped 5.7 times following application of pneumatic compression, suggesting the use of the procedure for erysipelas by stimulating lymph drainage.

Arm↗
PubMedDate not supplied

[Experimental study on erysipeloid arthritis in the rabbit after blockage of lymph drainage].

The lymph drainage was radically blocked in 29 rabbits. One to three days after the operation Erysipelothrix rhusiopathiae was inoculated subcutaneously into the animals. Some control animals were injected with agents of erysipelas and some only with the sterile solution without additional blockade of the lymph drainage. Light and electron microscopy as well as immuno-histological tests showed that the erysipelas arthritis developing in rabbits closely resembles human rheumatoid arthritis with exsudative-necrotising changes of the synovial membrane, proliferation of synovial cells and subsynovial, perivascular plasmacell, and lymphocyte infiltration. The changes were not intensified by the additional blockade of the lymph drainage, when comparing the side with lymph drainage blockade and the non-operated side. The results may be explained by a marked pathogenetic importance of the erysipelas infection in comparison to the relatively mild, lymphostate dependent alterations as well as by mobilisation of macrophages on the operated side.

Animals↗