Form Of Erysipelas Research Articles

ПРИМЕНЕНИЕ ПРЕПАРАТОВ ГИАЛУРОНОВОЙ КИСЛОТЫ В ЛЕЧЕНИИ ОБШИРНЫХ ДЕФЕКТОВ КОЖИ У ПАЦИЕНТОВ, СТРАДАЮЩИХ ДЕСТРУКТИВНЫМИ ФОРМАМИ РОЖИСТОГО ВОСПАЛЕНИЯ НИЖНИХ КОНЕЧНОСТЕЙ

and often requires surgical treatment. Due to the more common development of necrotic forms of erysipelas in patients with dysfunction of local reparative systems, there is a need to stimulate repair to eliminate defects, one of the variants of which may be hyaluronic acid (HA). Hyaluronic acid, which is an acidic mucopolysaccharide by chemical nature, is now widely used in medical practice. This is due to the anti-inflammatory effect, the ability to stimulate the processes of proliferation and epithelialization. We studied the effect of HA in 31 patients with destructive forms of erysipelas in comparison with 32 patients who received standard of care; the results obtained allow us to speak, at least, of numerical trends in favor of HA. Further research is required to evaluate the effect.

Necrotizing Fasciitis: a Clinical Case and a Review of the Literature

Abstract Necrotizing fasciitis is a soft tissue, life-threatening infection with a fulminant and often fatal course. Early diagnosis is usually delayed as the onset of the disease is often masked in the form of erysipelas or cellulite. The condition is characterized by necrosis of the skin, subcutaneous tissue and underlying fascia. We describe a case of a 42-year-old man with a complaint of erythema, fever and severe pain in his right leg 4 days before hospitalization. The patient was admitted and treated with a diagnosis of erysipelas. A few hours after admission, in connection with a drastic deterioration in the general condition and dermatological status, he was transferred to a purulentseptic ward with a fulminant picture of necrotizing fasciitis. Debridement and fasciotomy were performed successfully and timely. Good prognosis and survival in patients with NF correlate directly with the complex of measures. Appropriate antibiotics and intensive general support avoid massive systemic diffusion. Early and adequate surgical debridement and fasciotomy are associated with improved survival.

Some aspects of surgical treatment of erysipelas

Objective. To study the incidence and to determine the main trends of treatment of the erysipelas surgical forms.
 Materials and methods. There were retrospectively and prospectively analyzed 114 histories of the patients’ cases, who were treated in stationary in the centre of purulent-septic surgery of the Municipal Hospital No 3 of Zaporizhzhya in 2019 - 2020 yrs.
 Results. Mostly often the affection site was localized on the lower extremities. In bullous and phlegmonous forms of erysipelas the most frequent clinical signs of intoxication were general weakness, hyperthermia, muscular pain. In necrotic form of erysipelas the signs of severe intoxication with nausea, regurgitation and confusion were observed. In complex treatment of erysipelas the main principles are antibioticotherapy and early surgical processing of the pathological process zone. Determination of indices of the procalcitonin content in the blood serum gives possibility to estimate progression and generalization of the process and constitutes a sensitive test for efficacy of the treatment conducted.
 Conclusion. Radical surgical intervention and timely targeted antibioticotherapy constitutes basic elements of successful treatment for surgical forms of erysipelas, and this position must not be revised. Procalcitonin content in the blood serum constitutes a diagnostic marker, permitting to prognosticate the sepsis development timely.

EVALUATION OF TOPICAL APPLICATION OF BACTERIOPHAGES IN THE TREATMENT OF ERYSIPELAS

Erysipelas is known as a human infectious disease, which, unfortunately, in recent years has not reduced its incidence rate in spite of all the advances of medicine. There is a tendency to an increase in the incidence of complicated forms of erysipelas, the consequences of which require prolonged conservative treatment and expenses. Moreover, there is a transition to recurrent forms often associated with large-scale surgical interventions and sometimes plastic surgeries to close skin defects. Thus, the search for best options for treating erysipelas, preventing its recurrence or transition to more severe clinical forms is an urgent issue that requires research aimed at improving the integrated treatment of this pathology. One of the solutions to this problem is the use of bacteriophages in combination with the standard treatment of erysipelas. The aim of the study was to improve the clinical results of erysipelas complex treatment by adding local bacteriophage therapy. Our clinical study included 28 patients with erythematous and erythematous-bullous forms of erysipelas. Two groups of patients were made up to compare the efficacy of the combined use of bacteriophages and standard antibacterial therapy. Evaluation of the efficacy was performed by clinical and microbiological methods. Based on the results of clinical study, we have found out that topical use of bacteriophages incorporated into dressing material in the course of erysipelas treatment, in addition to standard antibacterial therapy and detoxification leads to a statistically significant decrease in the duration of hyperthermic reactions in patients by 0.6 ± 0.13 days, lowering in intensity and the duration of pain syndrome by 0.9 ± 0.21 days, a more rapid local swelling fading by 0.5 ± 0.3 days, enhanced decrease in local skin hyperemia by 27% and accelerated microbial decontamination in the lesion areas by 21%. The results obtained allow us to recommend applying local bacteriophage treatment as a part of the standard management of erysipelas to promote the healing period and to improve the clinical condition of patients.

Application of derinat and titanium glycerosolvate aquacomplex in treatment of destructive forms of erysipelas

OBJECTIVE. The authors researched the ways of improvement of treatment results in patients with complicated forms of erysipelas. MATERIAL AND METHODS. There were examined 68 patients with erysipelas complicated by abscess, phlegmon or necrosis of soft tissues. Basic treatment was used for the first group of patients. Combination of basic treatment and application of titanium glycerosolvate aquacomplex were carried out in the second group. Basic treatment and immunomodulator Derinat were applied in the third group. Combined therapy including titanium glycerosolvate aquacomplex and Derinat was used in the fourth group. RESULTS. Prescription of Derinat for patients with erysipelas allowed doctors to eliminate symptoms of general intoxication in more earlier terms compared with сonventional treatment. The application of Derinat stimulated T-and B-сomponents of immune system. The local application of Tizol facilitated to earlier decrease of inflammation and it stimulated regeneration processes in the wound. CONCLUSIONS. The therapy of destructive forms of erysipelas which included Derinat and Tizol shortened the terms of cleansing and repair of purulent wounds. This method increased the efficacy of treatment of given class of patients.

Érysipèle sans fièvre ni syndrome inflammatoire lors d’un traitement par tocilizumab

Tocilizumab (TCZ) is a monoclonal antibody that inhibits the interleukin 6 (IL-6) signalling pathway. This treatment is extremely effective in rheumatoid arthritis (RA), which may well be accompanied by serious infections presenting misleading clinical pictures. Herein we report a case of a typical bacterial dermo-hypodermitis in a female patient treated with TCZ. An 80-year-old woman treated with methotrexate (MTX) and TCZ for RA presented dermo-hypodermitis on her left leg 8 days after receiving her 13th infusion of TCZ. She exhibited neither fever nor biological inflammatory syndrome. Oral amoxicillin (3g/d) was initiated on an outpatient basis. Two weeks later, the patient was apyretic and her laboratory results were normal, although local inflammatory signs persisted. TCZ infusion was postponed and she was given intravenous amoxicillin (4g/d) for 2days, followed by oral amoxicillin, resulting in rapid recovery. Subsequent courses of TCZ were administered without incident. During the course of treatment with TCZ, this patient presented delineated bacterial cellulitis in the form of erysipelas, which was noteworthy on account of the absence of fever and of biological inflammatory syndrome. While there have been reports of severe cases of cellulitis during TCZ treatment, to our knowledge, there have been none of erysipelas. Attenuation of local and systemic inflammatory symptoms is widely reported, and is directly associated with the anti-IL-6 action of TCZ. Patients with RA are especially susceptible to opportunistic or severe infections as a result of the disease itself and of associated treatments, and increased vigilance is called for with regard to infections that may be transformed and potentially more severe as a result of TCZ.

The migration activity of leukocytes as indicator of hyper-sensitivity of delayed type in patients with erysipelas.

The hyper-sensitivity of delayed type is one of important manifestations of cellular immunity. The successful studying of this phenomenon can favor solution of actual issues of pathogenesis, diagnostics and treatment of bacterial infections. The present review considers hyper-sensitivity of delayed type as an important area of cellular immunity under infectious pathology and macrophage-inhibiting factor as an important lymphocyte mediator: cytokine and hormone. The model of intestinal infections and erysipelas was used to demonstrate an important diagnostic and prognostic value of screening test of cellular migration as a simple, handy in application and reading of results, relatively new technique permitting to evaluate both acceleration of migration of leukocytes at height of disease and inhibition of migration in re-convalescence of disease. The establishment of character and dynamics of migration activity of leukocytes on partial genes antigens S.pyogenes in screening test of cellular migration can be used in diagnostics of various forms of erysipelas, evaluation of expression of intoxication, prognosis of complications and relapses. The disturbance of dynamics of migration activity of leukocytes testifies failure of immune response to agent.

ASSESSMENT OF THE DEGREE OF INTOXICATION AND THE FORECAST LEVEL OF THE INTEGRAL INDEX OF INTOXICATION UNDER CERTAIN INFECTIOUS DISEASES

The Purpose of this research was to study indicators syndrome of endogenous intoxication in patients with erysipelas and herpes infection that can be used to predict relapse in these diseases. Based on the goal were examined in 54 patients with primary, erythematous form of erysipelas of different localization and 42 patients with the localized form of herpes infection in the dynamics of these diseases. Determined the level of substances of low and medium molecular weight (HV and SMM), and oligopeptides, as well as the Integral index of intoxication by the method of M. I. Malakhov (1994) and Lowry (1991). To assess the value of the Integral index of intoxication in the prediction of relapses were calculated odds ratio. Revealed the dependence of studied parameters of disease and completeness of recovery. Level measurement HV and SMM and oligopeptides allows us to calculate the Integral index of intoxication, which can be used as a prognostic criterion of recurrence as erysipelas, and herpes infection.

Современные молекулярно-биологические методы в изучении этиологии буллезно‑геморрагической формы рожи нижних конечностей

Современные молекулярно-биологические методы в изучении этиологии буллезно‑геморрагической формы рожи нижних конечностей

Hodges a. Berger X-ray therapy of some infectious skin diseases (J sm. M. Ass. V. 107, No. 19, 7 / XI, 1936)

The authors divided infectious diseases to be treated with X-rays into two groups, guided not by the etiological moment, but by their sensitivity and receptivity in relation to radiant energy. From this point of view, the first group included: early localized forms of erysipelas in adults, boils, granulomas, infected hemangiomas, a certain type of cellulitis and lymphangitis, Mikulich's disease, parotitis and rhinophyma. The second: carbuncles, blastomycosis and sporotrichosis.

ERYSIPELAS

The observations which follow are drawn from my experience with 800 cases of erysipelas which have been under my care in the erysipelas wards of Bellevue Hospital during seven periods of service from February, 1909, to April, 1913, an aggregate of forty-two weeks. <h3>DURATION</h3> So many claims have been advanced for the efficacy of various forms of treatment in limiting the duration or extent of this disease, that I have had especially in mind to determine the average febrile period of various forms of erysipelas (drawn from a large series of cases practically untreated), in order that there might be a background on which the effects of treatment might be contrasted. In reckoning the febrile period, I have counted the days from the onset of the disease until the rectal temperature has remained at or below 100. Uncomplicated facial erysipelas cases (500) ran an average duration of 6.77 days.

THE ILL-HEALTH OF RICHARD WAGNER.

The following quotations are from the life by Glasenapp and Ellis, and from the volumes of letters to Heckel, Wesedonck and Liszt. I regret exceedingly that the reproduction here of so large a number of excerpts is necessary. I have omitted many that seemed possible to be spared and not spoil the clinical picture. Only by the careful reading can one get a clear idea of Wagner's sufferings and symptoms, and be thus enabled to come to a sound diagnosis of the one malady that resulted in such various and lifelong symptoms. Richard Wagner was born in 1813. His delicate constitution required peculiar care, for he was already troubled with that irritating form of erysipelas (erythema or eczema?) which recurred at intervals throughout life... Down to his sixth year he had no regular lessons; the mother wished to give him time to pick up strength, and would not have plagued

THE ILL-HEALTH OF RICHARD WAGNER.

The following quotations are from the life by Glasenapp and Ellis, and from the volumes of letters to Heckel, Wesedonck and Liszt. I regret exceedingly that the reproduction here of so large a number of excerpts is necessary. I have omitted many that seemed possible to be spared and not spoil the clinical picture. Only by the careful reading can one get a clear idea of Wagner's sufferings and symptoms, and be thus enabled to come to a sound diagnosis of the one malady that resulted in such various and lifelong symptoms. Richard Wagner was born in 1813. His delicate constitution required peculiar care, for he was already troubled with that irritating form of erysipelas (erythema or eczema?) which recurred at intervals throughout life... Down to his sixth year he had no regular lessons; the mother wished to give him time to pick up strength, and would not have plagued