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Magnus Rasmussen - One of the best experts on this subject based on the ideXlab platform.

  • Colonization of β-hemolytic streptococci in patients with Erysipelas-a prospective study.
    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2019
    Co-Authors: Kristina Trell, Sofia Rignér, Marcelina Wierzbicka, Bo Nilson, Magnus Rasmussen
    Abstract:

    Erysipelas is a common skin infection causing significant morbidity. At present there are no established procedures for bacteriological sampling. Here we investigate the possibility of using cultures for diagnostic purposes by determining the perianal colonization with beta-hemolytic streptococci (BHS) in patients with Erysipelas. Patients with Erysipelas and a control group of patients with fever without signs of skin infection were prospectively included and cultures for BHS were taken from the tonsils, the perianal area, and wounds. BHS were grouped according to Lancefield antigen, species-determined, and emm-typed. Renewed cultures were taken after four weeks from patients with Erysipelas and a positive culture for BHS. 25 patients with Erysipelas and 25 with fever were included. In the group with Erysipelas, 11 patients (44%) were colonized with BHS, ten patients were colonized in the perianal area, and one patient in the throat. In contrast, only one patient in the control group was colonized (p = 0.005 for difference). All of the patients with Erysipelas colonized with BHS had an erythema located to the lower limb. The BHS were then subjected to MALDI-TOF MS and most commonly found to be Streptococcus dysgalactiae. Renewed cultures were taken from nine of the 11 patients with BHS and three of these were still colonized. Streptococcus dysgalactiae colonizes the perianal area in a substantial proportion of patients with Erysipelas. The possibility of using cultures from this area as a diagnostic method in patients with Erysipelas seems promising.

  • A Case of Recurrent Erysipelas Caused by Streptococcus mitis Group
    Case reports in infectious diseases, 2018
    Co-Authors: David Nygren, Bo Nilson, Magnus Rasmussen
    Abstract:

    The aetiology of Erysipelas remains poorly defined though beta-haemolytic streptococci are considered as the main causative pathogens. We describe a case of a 70-year-old woman with recurrent Erysipelas in her left arm due to infection with streptococci of the mitis group. Her past medical history includes lymphoedema of the left arm secondary to lymph node dissection due to breast cancer surgery. On seven different occasions during a decade, she has presented a clinical picture of Erysipelas and in three of them with Streptococcus mitis group bacteraemia. The results indicate that two cases were caused by Streptococcus mitis and one case was caused by Streptococcus oralis. This is, to our knowledge, the first reported cases of S. mitis and of S. oralis as the causative agents of Erysipelas.

  • Erysipelas, a large retrospective study of aetiology and clinical presentation
    BMC Infectious Diseases, 2015
    Co-Authors: Anna Bläckberg, Kristina Trell, Magnus Rasmussen
    Abstract:

    Background Erysipelas is a common and severe infection where the aetiology and optimal management is not well-studied. Here, we investigate the clinical features, bacteriological aetiology, and treatment of Erysipelas. Methods Episodes of Erysipelas in a seven-years period in our institution were studied retrospectively using a pre-specified protocol and is presented with descriptive and comparative statistics. Results 1142 episodes of Erysipelas were identified in 981 patients. Patients had a median age of 61 years, 59 % were male, a majority had underlying diseases or predisposing conditions, and the leg was most often affected. Wound cultures were taken in 343 episodes and 56 grew group A streptococci (GAS), 53 grew group G streptococci (GGS), 11 grew group C streptococci (GCS), and 153 grew Staphylococcus aureus. Blood cultures were drawn in 49 % of episodes and 50 cultures were positive with GGS as the most common finding (21 cultures) followed by GAS in 13, group B streptococci in 5, S. aureus in 4, and GCS in 3 cultures. In 45 % of episodes, patients received antibiotics with activity against S. aureus. Conclusions GGS is the most common streptococcus isolated in Erysipelas and the role of S. aureus in Erysipelas remains elusive.

  • Erysipelas, a large retrospective study of aetiology and clinical presentation
    BMC infectious diseases, 2015
    Co-Authors: Anna Bläckberg, Kristina Trell, Magnus Rasmussen
    Abstract:

    Erysipelas is a common and severe infection where the aetiology and optimal management is not well-studied. Here, we investigate the clinical features, bacteriological aetiology, and treatment of Erysipelas. Episodes of Erysipelas in a seven-years period in our institution were studied retrospectively using a pre-specified protocol and is presented with descriptive and comparative statistics. 1142 episodes of Erysipelas were identified in 981 patients. Patients had a median age of 61 years, 59 % were male, a majority had underlying diseases or predisposing conditions, and the leg was most often affected. Wound cultures were taken in 343 episodes and 56 grew group A streptococci (GAS), 53 grew group G streptococci (GGS), 11 grew group C streptococci (GCS), and 153 grew Staphylococcus aureus. Blood cultures were drawn in 49 % of episodes and 50 cultures were positive with GGS as the most common finding (21 cultures) followed by GAS in 13, group B streptococci in 5, S. aureus in 4, and GCS in 3 cultures. In 45 % of episodes, patients received antibiotics with activity against S. aureus. GGS is the most common streptococcus isolated in Erysipelas and the role of S. aureus in Erysipelas remains elusive.

  • Recurrent Erysipelas--risk factors and clinical presentation.
    BMC infectious diseases, 2014
    Co-Authors: Malin Inghammar, Magnus Rasmussen, Adam Linder
    Abstract:

    Erysipelas is a common infection that often recurs, but the impact of specific risk factors for reoccurrence remains elusive. In the present study we aimed at clarifying predisposing conditions for reoccurrence. Medical records were reviewed from all patients ≥18 years of age diagnosed with Erysipelas at the Department of Infectious Diseases at Skåne University Hospital, Sweden, from January 2007 to February 2011. 502 patients were included, of which 357 were single episode Erysipelas and 145 had recurrent Erysipelas. These two groups were compared regarding underlying conditions and clinical presentation. Erysipelas in the lower limbs had the greatest propensity of recurrence. The associations between underlying conditions and recurrence were largely depending on the site of Erysipelas. Overall, the most prominent risk factor for recurrence was lymphedema and other conditions causing a chronic impairment of the defence against microbes. Conditions temporarily disrupting the skin barrier (e.g. a local wound or toe web intertrigo), although likely being risk factors for Erysipelas per se, did not seem to predispose to repeated episodes. Individuals with recurrent Erysipelas tended to seek medical attention earlier, and were less likely to be hospitalized or receive intravenous antibiotics, but there was no evidence of any difference in inflammatory reaction when taking confounding factors into account. In this large cross-sectional study of over 500 patients with Erysipelas, lymphedema was the most prominent risk factors for recurrence although the distribution of predisposing conditions varies depending on the site of Erysipelas.

Albert A Rizvanov - One of the best experts on this subject based on the ideXlab platform.

  • The Role of CYP1A1 Gene Polymorphism in Patients with Erysipelas
    BioNanoScience, 2017
    Co-Authors: Veronika V. Kadkina, Irina E Kravchenko, Gulnaz L. Aybatova, Nadezhda V. Lukina, Olga Kozlova, Albert A Rizvanov
    Abstract:

    The research aims are to study the role of CYP1A1 gene polymorphism in predisposition to Erysipelas and reveal connections with the clinical course of the disease. We used the standard techniques of molecular genetic analysis. The DNA samples used in genotyping were extracted from leukocytes of venous blood by deproteinization with a phenol-chloroform mixture. Genotyping was performed by polymerase chain reaction (PCR). Statistical data relating to the investigated polymorphic markers were estimated at a 95% confidence level (CL). Genotype frequencies were compared using either the standard Pearson’s chi-squared test or the two-sided Fisher’s exact test. This study presents a comparative analysis of the distribution of gene polymorphisms of cytochrome P450 CYP1A1 (Ile462Val, rs1048943) of phase I detoxification (microsomal oxidation) in the experimental group of 71 patients with Erysipelas and a control group of 71 healthy individuals. We also analyzed these relationships of CYP1A1 (Ile462Val) gene polymorphisms with the sex of the patients, the severity and multiplicity of the disease, and the nature of the local process in patients with Erysipelas. The results of the investigation indicate the presence of a relationship between cytochrome P450 CYP1A1 (Ile462Val, rs1048943) gene polymorphism and the development of Erysipelas. Analysis of these relationships of CYP1A1 (Ile462Val) gene polymorphism with the sex of the patients, the severity and multiplicity of the disease, and the nature of the process in the examined group of patients with Erysipelas did not reveal any statistically significant differences.

  • analysis of serum cytokines and single nucleotide polymorphisms of sod1 sod2 and cat in Erysipelas patients
    Clinical & Developmental Immunology, 2017
    Co-Authors: Charles Emene, Irina E Kravchenko, Gulnaz I Aibatova, Albert A Rizvanov
    Abstract:

    Increased free radical production had been documented in group A (β-hemolytic) streptococcus infection cases. Comparing 71 Erysipelas patients to 55 age-matched healthy individuals, we sought for CAT, SOD1, and SOD2 single polymorphism mutation (SNPs) interactions with Erysipelas' predisposition and serum cytokine levels in the acute and recovery phases of Erysipelas infection. Whereas female patients had a higher predisposition to Erysipelas, male patients were prone to having a facial localization of the infection. The presence of SOD1 G7958, SOD2 T2734, and CAT C262 alleles was linked to Erysipelas' predisposition. T and C alleles of SOD2 T2734C individually were linked to patients with bullous and erythematous Erysipelas, respectively. G and A alleles of SOD1 G7958A individually were associated with lower limbs and higher body part localizations of the infection, respectively. Serum levels of IL-1β, CCL11, IL-2Rα, CXCL9, TRAIL, PDGF-BB, and CCL4 were associated with symptoms accompanying the infection, while IL-6, IL-9, IL-10, IL-13, IL-15, IL-17, G-CSF, and VEGF were associated with predisposition and recurrence of Erysipelas. While variations of IL-1β, IL-7, IL-8, IL-17, CCL5, and HGF were associated with the SOD2 T2734C SNP, variations of PDFG-BB and CCL2 were associated with the CAT C262T SNP.

J.w.m. Van Der Meer - One of the best experts on this subject based on the ideXlab platform.

  • Pitfall of modern genetics: recurrent Erysipelas masquerading as autoinflammatory disease.
    The Netherlands journal of medicine, 2017
    Co-Authors: E. J. W. Spierings, J.w.m. Van Der Meer, Anna Simon
    Abstract:

    A patient presented with recurrent episodes of fever and skin rash for eight years. DNA analysis of the NLRP3 gene revealed a mutation associated with autoinflammatory disease. After an initial positive response to the biological anakinra, the patient deteriorated. Reassessment revealed recurrent Erysipelas. In conclusion, sometimes Erysipelas-like skin rash is real Erysipelas, and DNA results are not always the final answer.

  • recurrent Erysipelas despite antibiotic prophylaxis an analysis from case studies
    Netherlands Journal of Medicine, 2007
    Co-Authors: J.b. Koster, B.j. Kullberg, J.w.m. Van Der Meer
    Abstract:

    A B s T r A C T Background: Erysipelas is a distinctive type of superficial cellulitis of the skin with prominent lymphatic involvement, generally caused by group A streptococci. A substantial proportion of patients experience recurrences of Erysipelas, and this may be a reason to install prophylactic antibiotic treatment. despite such prophylaxis, further recurrences are occasionally encountered. objectives: To investigate recurrences of Erysipelas during prophylactic antibiotic treatment and to delineate the reasons for such failure. Methods: retrospective chart review of 117 adult patients with episodes of Erysipelas known in our institution between 1990 and 2004. results: recurrent episodes of Erysipelas, despite prophylactic treatment, were found in eight patients. our analysis indicated noncompliance, incorrect selection and insufficient dosing of antibiotics, and causative pathogens other than streptococci as demonstrable causes of the recurrence of Erysipelas. in three patients, a reason for failure could not be identified. Conclusions: in a minority of cases, Erysipelas recurs despite antibiotic prophylaxis. Based on these cases, we first recommend that all efforts are made to (re)confirm the diagnosis of Erysipelas and search for the causative microorganism. Based on this information, the right antibiotic with adequate dosing and timing can be selected. The issue of compliance with the prophylactic treatment should be addressed and finally, the clinician should be aware that prophylaxis does not prevent Erysipelas in all cases.

  • Recurrent Erysipelas despite antibiotic prophylaxis: an analysis from case studies.
    The Netherlands journal of medicine, 2007
    Co-Authors: J.b. Koster, B.j. Kullberg, J.w.m. Van Der Meer
    Abstract:

    Erysipelas is a distinctive type of superficial cellulitis of the skin with prominent lymphatic involvement, generally caused by group A streptococci. A substantial proportion of patients experience recurrences of Erysipelas, and this may be a reason to install prophylactic antibiotic treatment. Despite such prophylaxis, further recurrences are occasionally encountered. To investigate recurrences of Erysipelas during prophylactic antibiotic treatment and to delineate the reasons for such failure. Retrospective chart review of 117 adult patients with episodes of Erysipelas known in our institution between 1990 and 2004. Recurrent episodes of Erysipelas, despite prophylactic treatment, were found in eight patients. Our analysis indicated noncompliance, incorrect selection and insufficient dosing of antibiotics, and causative pathogens other than streptococci as demonstrable causes of the recurrence of Erysipelas. In three patients, a reason for failure could not be identified. In a minority of cases, Erysipelas recurs despite antibiotic prophylaxis. Based on these cases, we first recommend that all efforts are made to (re)confirm the diagnosis of Erysipelas and search for the causative microorganism. Based on this information, the right antibiotic with adequate dosing and timing can be selected. The issue of compliance with the prophylactic treatment should be addressed and finally, the clinician should be aware that prophylaxis does not prevent Erysipelas in all cases.

Charles Emene - One of the best experts on this subject based on the ideXlab platform.

  • analysis of serum cytokines and single nucleotide polymorphisms of sod1 sod2 and cat in Erysipelas patients
    Clinical & Developmental Immunology, 2017
    Co-Authors: Charles Emene, Irina E Kravchenko, Gulnaz I Aibatova, Albert A Rizvanov
    Abstract:

    Increased free radical production had been documented in group A (β-hemolytic) streptococcus infection cases. Comparing 71 Erysipelas patients to 55 age-matched healthy individuals, we sought for CAT, SOD1, and SOD2 single polymorphism mutation (SNPs) interactions with Erysipelas' predisposition and serum cytokine levels in the acute and recovery phases of Erysipelas infection. Whereas female patients had a higher predisposition to Erysipelas, male patients were prone to having a facial localization of the infection. The presence of SOD1 G7958, SOD2 T2734, and CAT C262 alleles was linked to Erysipelas' predisposition. T and C alleles of SOD2 T2734C individually were linked to patients with bullous and erythematous Erysipelas, respectively. G and A alleles of SOD1 G7958A individually were associated with lower limbs and higher body part localizations of the infection, respectively. Serum levels of IL-1β, CCL11, IL-2Rα, CXCL9, TRAIL, PDGF-BB, and CCL4 were associated with symptoms accompanying the infection, while IL-6, IL-9, IL-10, IL-13, IL-15, IL-17, G-CSF, and VEGF were associated with predisposition and recurrence of Erysipelas. While variations of IL-1β, IL-7, IL-8, IL-17, CCL5, and HGF were associated with the SOD2 T2734C SNP, variations of PDFG-BB and CCL2 were associated with the CAT C262T SNP.

Alicja Wiercinskadrapalo - One of the best experts on this subject based on the ideXlab platform.

  • in search of risk factors for recurrent Erysipelas and cellulitis of the lower limb a cross sectional study of epidemiological characteristics of patients hospitalized due to skin and soft tissue infections
    Interdisciplinary Perspectives on Infectious Diseases, 2020
    Co-Authors: Mariusz Sapula, Dagny Krankowska, Alicja Wiercinskadrapalo
    Abstract:

    Background. Erysipelas and cellulitis are common, acute, bacterial infections of the skin and subcutaneous tissue. The incidence of these infections is growing, and the recurrence rate is high. Effective antibiotic prophylaxis is available, but insufficient data exist on the risks factors for recurrent infection. Purpose. To compare comorbidities and laboratory findings in patients with single-episode and recurrent Erysipelas/cellulitis in order to identify risk factors for recurrent Erysipelas/cellulitis. Methods. A cross-sectional study, which included patients hospitalized in the Department of Infectious and Tropical Diseases and Hepatology of the Medical University of Warsaw due to Erysipelas and cellulitis during 3 consecutive years (July 2016–June 2019). Results. The study included 163 patients, of which 98 had a first episode of Erysipelas/cellulitis and 65 had a recurrence. The recurrent infection was significantly associated with a history of lymphedema (12.3% in the recurrent group vs. 2.0% in the first-episode group, ), a higher BMI (35.4 vs. 31.2, respectively, ), chronic obstructive pulmonary disease (10.8% vs. 2.0%, ), and a shorter history of symptoms prior to hospitalization (6.0 days vs. 11.8 days, ). Patients with the first episode of infection were more likely to have had minor local trauma directly preceding the symptoms of infection (20.4% in the first-episode group vs. 1.5% in the recurrent group, ). Conclusions. Patients with lymphedema and obesity should be viewed at high risk of developing recurrence of Erysipelas and thus should be considered as candidates for antibiotic prophylaxis and other prevention methods. Minor local trauma directly preceding the skin infection does not by itself confer a higher risk for Erysipelas recurrence. More research is needed to assess the association of recurrent skin and soft-tissue infection to preceding minor local trauma, individual components of the metabolic syndrome, and COPD.