Prediction Degree Severity of Erysipelas: Risk Index of Hemorrhagic Form of Erysipelas

Abstract

Purpose of the study: The work is devoted to the new method diagnostics of hemorrhagic form of erysipelas as a method of early prediction of severe (hemorrhagic and erythematous-bullous-hemorrhagic) erysipelas forms. The advantage of the method - the ability to carry out the forecast of severe erysipelas in the early stages of the disease (1-2 days). The method allows differentiating patients quickly by severity of the disease to optimize therapeutic measures. Materials and methods: The patients with focus of inflammation localized on the face (n=24), and the legs (n=36) were studied at various stages of the disease (day 1-3; 4-6; 7-10; and 11-15 from the onset of the disease), undergoing in hospital treatment in Moscow 2nd Clinical Hospital for the Infectious Diseases. Summary in correlation multivariate analysis were examined 60 biochemical and hemostasis factors. Results: The hemorrhagic form of erysipelas diagnosed in 51.6% of all observations. The erysipelas severity index is calculated as: 3.075-0.009 x «Amylase, serum (IU/l)»+0,841 x «Erysipelas localization (face=1, LL=2)»+0.004 x «CRP, serum (mg/l)»-0.071x«Albumin, serum (g/l)»+0.027 x «AST, serum (IU/l); where: 3.075 -non-standardized coefficient; the total amylase in serum (IU/l); the erysipelas localization (face=1, LL=2); the C-reactive protein in serum (mg/l); the albumin in blood serum (g/l); the aspartate aminotransferase in serum (IU/l). Conclusions: The risk of hemorrhagic erysipelas in that group was in 9.9 times higher-if erysipelas inflammation was on the legs differentiate with the face (Odd Ratio=9.9 [2.8; 34.7]). The proposed risk index of hemorrhagic form of erysipelas is simple to calculate and easy to use.