Celulitis y erisipela: Manejo en atención primaria

ALBERTO FICA C
2003 Revista chilena de infectología  
Celulitis y erisipela: Manejo en atención primaria ALBERTO FICA C. 1 Cellulitis and erysipelas: Management in primary care Cellulitis and erysipelas are important causes of morbidity and hospital admissions. Erysipelas has a characteristic clinical manifestation and is associated typically to Streptococcus pyogenes and less frequently to group B, C or G Streptococci. The most relevant risk factors for erysipelas are lymphoedema and local skin lesions. Raised anti-streptolysin O antibodies may
more » ... O antibodies may support diagnosis of erysipelas but are present in no more than 40% of cases. Therapy of choice is penicillin or amoxicillin and the length and route of administration is dictated by clinical severity. Cellulitis is a spreading infection of skin and subcutaneous structures without palpable margins. It has a broader etiological spectrum than erysipelas including S. pyogenes and Staphylococcus aureus. Resistance of the latter microrganism to penicillin demands an antimicrobial scheme based either on cloxacillin, antistaphylococcal cefalosporins (i.e. cefazolin), clindamycin or beta lactam -beta-lactamase inhibitor combinations. Emergence of invasive S. pyogenes infections imposes a proper and early recognition of this condition. Clues for this suspicion are hypotension, a rapidly evolving condition, tisular necrosis and rush. These infections should be managed by parenteral antibiotics, supportive therapy and aggressive surgical debridement.
doi:10.4067/s0716-10182003000200004 fatcat:l3y4kcizfrcqpdo4e4vxiaidwm