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Erysipelas

Sist oppdatert: Sist revidert:
Sist revidert av:

Definisjon:
Lokal, avgrenset, overflatisk hudinfeksjon forårsaket av beta-hemolytiske streptokokker
Forekomst:
Relativt hyppig, epidemiologiske data for Norge mangler
Symptomer:
Ømt og varmt erytem, sjelden smertefullt, allmennsymptomer
Funn:
Homogent, skarpt avgrenset, lokalisert erytem, ofte illrødt (lakserødt). Lett elevert og skarpt avgrenset hevelse, lokale glandelstasjoner og ev. ledsagende lymfangitt
Diagnostikk:
Klinisk diagnostikk med typisk sykehistorie, utseende, CRP (ev. leukocytose. Dyrkningsprøver er sjelden til hjelp
Behandling:
Betalaktamantibiotika, elevasjon og ev. febernedsettende
  1. Helsedirektoratet (2021). Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 16. november 2021, lest jan 2022).
  2. Bläckberg A, Trell K, Rasmussen M. Erysipelas, a large retrospective study of aetiology and clinical presentation. BMC Infect Dis. 2015 Sep 30;15:402. PMID: 26424182. PubMed  
  3. Bruun T, Oppegaard O, Kittang BR, et al. Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study. Open Forum Infect Dis. 2015 Nov 25;3(1):ofv181. PMID: 26734653.
  4. Hirschmann JV, Raugi GJ. Lower limb cellulitis and its mimics: part I. Lower limb cellulitis. J Am Acad Dermatol 2012; 67: 163. pmid:22794815 PubMed  
  5. Oppegaard O, Mylvaganam H, Kittang BR. Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey. Clin Microbiol Infect. 2015 Feb;21(2):171-8. Epub 2014 Oct 14. PMID: 25658557. PubMed  
  6. Goettsch WG, Bouwes Bavinck JN, Herings RM. Burden of illness of bacterial cellulitis and erysipelas of the leg in the Netherlands. J Eur Acad Dermatol Venereol 2006;20:834-839. PubMed  
  7. McNamara DR, Tleyjeh IM, Berbari EF. Incidence of lower-extremity cellulitis: a population-based study in Olmsted county, Minnesota. Mayo Clin Proc 2007; 82: 817. pmid:17605961 PubMed  
  8. Norsk barnelegeforening, pediatriveileder: Erysipelas (Rosen). Sist revidert 2012. Nettsiden besøkt 04.01.21. www.helsebiblioteket.no  
  9. Rath E, Skrede S, Mylvaganam H, Bruun T. Aetiology and clinical features of facial cellulitis: a prospective study. Infect Dis (Lond). 2018 Jan;50(1):27-34. Epub 2017 Aug 2. PMID: 28768452. PubMed  
  10. Gunderson CG, Martinello RA. A systematic review of bacteremias in cellulitis and erysipelas. J Infect 2012;64:148-155. PubMed  
  11. Trell K, Rignér S, Wierzbicka M, Nilson B, Rasmussen M. Colonization of β-hemolytic streptococci in patients with erysipelas-a prospective study. Eur J Clin Microbiol Infect Dis. 2019 Oct;38(10):1901-1906. Epub 2019 Jul 10. PMID: 31292789. PubMed  
  12. Eriksson BKG, Karkkonen K, Jorup-Rönström C, Wretlind B. Frequent colonization of betahaemolytic streptococci at various body sites including the perineum and anal canal during erysipelas and cellulitis. Infect Dis (Lond). 2019 Jul;51(7):534-540. Epub 2019 May 15. PMID: 31088328. PubMed  
  13. Dupuy A, Benchikhi H, Roujeau J-C, et al. Risk factors for erysipelas of the leg (cellulitis): case-control study. BMJ 1999; 318: 1591-4. British Medical Journal  
  14. Stevens DL, Bisno AL, Chambers HF. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America. Clin Infect Dis 2014; 59: e10. pmid:24973422 PubMed  
  15. Rath E, Skrede S, Oppegaard O, Bruun T. Non-purulent skin and soft tissue infections: predictive power of a severity score and the appropriateness of treatment in a prospective cohort. Infect Dis (Lond). 2020 May;52(5):361-371. Epub 2020 Feb 13. PMID: 32052670. PubMed  
  16. Bruun T, Oppegaard O, Hufthammer KO, et al. Early Response in Cellulitis: A Prospective Study of Dynamics and Predictors. Clin Infect Dis. 2016 Oct 15;63(8):1034-1041. Epub 2016 Jul 11. PMID: 27402819. PubMed  
  17. Brindle R.J, O’Neill L.A, Williams OM. Risk, Prevention, Diagnosis, and Management of Cellulitis and Erysipelas. Curr Derm Rep 9, 73–82 (2020). https://doi.org/10.1007/s13671-020-00287-1
  18. Helsedirektoratet. Erysipelas. Nasjonal faglig retningslinje for bruk av antibiotika i sykehus. Sist faglig oppdatert jan. 2018. Siden lest 16.11.2020. www.helsedirektoratet.no  
  19. Inghammar M, Rasmussen M, Linder A. Recurrent erysipelas--risk factors and clinical presentation. BMC Infect Dis. 2014 May 18;14:270. PMID: 24884840. PubMed  
  20. Oppegaard O, Skrede S, Mylvaganam H, Kittang BR. Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci. Front Microbiol. 2020 May 15;11:797. PMID: 32477287. PubMed  
  • Eivind Rath, indremedisiner og infeksjonslege, Haukeland Universitetssjukehus, Bergen

Tidligere fagmedarbeidere

  • Bjørn Waagsbø, overlege St Olavs Hospital, Trondheim