COMPLEX TREATMENT OF COMPLICATED FORMS OF ERYSIPELAS

Abstract

Summary. Objectives: to analyze the immediate results of the complex treatment of complicated forms of erysipelas.
 Methods: A retrospective analysis of the immediate results of complex treatment of 67 patients with complicated forms of erysipelas was conducted. There were 29 (43.3%) men, 38 (56.7%) women. The average age was 65.1 years.
 Results: The duration of symptoms of the disease before hospitalization varied from 3 to 14 days. The erythematous form of erysipelas was found in 7 (10.5%), erythematous-hemorrhagic – in 14 (20.9%), erythematous-bullous – in 21 (31.3%), bullous-hemorrhagic – in 25 (37.3 %). According to the localization, erysipelas of the head was found in 5 (7.5%), upper limbs - in 3 (4.5%), lower limbs - in 59 (88%). Primary erysipelas was present in 39 (58.2%), recurrent – in 28 (41.8%). In the picture of peripheral blood, leukocytosis is determined with a shift of the leukocyte blood formula to the left. The level of C-reactive protein is 18 - 100 times higher than the upper limit of normal. According to the results of cultures of scrapings of affected tissues, the dominance of Staphyloccus haemolyticus in associations with other gram-positive and gram-negative microorganisms was revealed. High polyresistance of Staphyloccus haemolyticus strains to antibacterial drugs with preservation sensitivity to Clindamycin, Vancomycin, Linezolid, and Teicoplatin was inserted.
 Conclusions: Complicated forms of erysipelas are found in 89.5% of patients who are being treated in the surgical department for erysipelas. The most frequent localization is erysipelas of the lower limbs, which is found in 88%. Staphylococcus haemolyticus is dominant among the causative agents of erysipelas in various associations with other gram-positive and gram-negative microorganisms. A high polyresistance of Staphylococcus haemolyticus strains to antibacterial drugs is determined, while sensitivity to clindamycin, vancomycin, linezolid, and teicoplanin is preserved. Treatment of erysipelas is complex, including antibacterial therapy, surgical treatment of complications, local treatment of wounds, drug corrective therapy of concomitant chronic pathology.