Erysipeloid

Rosenbach 1887.

Swine erysipelas

Local and systemic infection caused by Erysipelothrix rhusiopathiae.

• Infections occur exclusively in the summer months.
• Particularly affects fishermen, housewives, butchers, crab fishermen (crab dermatitis), button making (if made from bones).
• In 3.5% of all cat bites, E. rhusiopathiae could be detected.

Erysipelothrix rhusiopathiae is a non-motile, gram-positive rod. The pathogen passes through the skin through small injuries and infection occurs. Rarely, transmission can occur through food. Cat and dog bites can also lead to the appearance of erysipeloid.

• Incubation period: 2–7 days.
• Pathogen: Erysipelothrix rhusiopathiae.

• Localised erysipeloid
  • Most common form.
  • Mostly affecting the fingers or hands.
  • Partly pruritic, partly painful, bright red, spreading centrifugally, erysipelas-like erythema, often with a feeling of tension. In the course, there may be a central subsiding of the redness.
  • Generally good general condition.
• Diffuse cutaneous infection
  • Rarely occurs.
  • In this case, there is involvement of other localisations.
  • Urticaria or vesicles appear and usually there is the expression of febrile temperatures and arthralgias.
  • The ingestion of contaminated food is considered a possible trigger.
• Systemic infection with and without endocarditis
  • Systemic infection is extremely rare.
  • Mostly fever occurs. In approx. 40%, erysipeloid skin changes exist or can be determined from the medical history.
  • Serpiginous or bullous lesions may appear on the trunk and extremities.
  • Liver failure and immunosuppression are predisposing factors. Approximately 1/3 of all patients with systemic E. rhusiopathiae infection are alcoholics.
• As a possible complication, endocarditis is feared. In particular, the aortic valve may be involved. For 1/3 of patients, involvement of the heart valves is lethal, another 1/3 requires valve replacement.

• Anamnesis (important occupational history!)
• Clinical
• Bact. smear
• If necessary, take a sample biopsy (this is the best way to detect the pathogen).
• Blood cultures (often negative or misidentified as Lactobacillus or Enterococcus).

• Frequently on the hands, but any localisation possible.

• Bronchitis occurs after inhalation.
• Sepsis.
• Endocarditis
• Cardiac failure.
• Valvular perforation.
• Myocardial abscess.
• Renal failure.
• Abscesses (myocardial, cerebral, intra-abdominal, epidural and paravertebral).
• Meningitis.
• Endophtalmitis.
• Osteomyelitis.
• Septic arthritis.
• Pneumonia.
• Necrotising fasciitis.

• Vaccination for risk groups veterinarians, animal dealers.
• Wearing gloves in the well-defined situations that allow infection.

• Individual course. Healing occurs after 2 weeks to several months later.
• Provided no complication occurs, there is a good prognosis.
• No lasting immunity develops.

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