Skip to Content

Erysipelas

By

Wingfield E. Rehmus

, MD, MPH, University of British Columbia

Last full review/revision Apr 2021| Content last modified Apr 2021

Erysipelas is a superficial form of skin infection (cellulitis) typically caused by streptococci.

(See also Overview of Bacterial Skin Infections.)

Erysipelas is most commonly caused by Streptococcus bacteria. However, it can also be caused by other bacteria such as Staphylococcus aureus, including a strain of Staphylococcus called methicillin-resistant Staphylococcus aureus (MRSA). Erysipelas occurs most frequently on the legs and face.

Symptoms

Erysipelas causes a shiny, painful, red, raised patch on the skin. The edges have distinct borders and do not blend into the nearby normal skin. The patch feels warm and firm to the touch. It occurs most frequently on the legs and face. In some forms of erysipelas, blisters form on the skin. People often have a high fever, chills, and a general feeling of illness (malaise).

Diagnosis

  • A doctor's evaluation

Doctors base the diagnosis of erysipelas on the characteristic appearance of the rash.

Sometimes doctors send blood samples to a laboratory to identify the bacteria (called a culture) if the person is very sick.

Treatment

  • Antibiotics

Antibiotics given by mouth, such as penicillin, can cure the infection. If doctors suspect the person has MRSA, the antibiotics trimethoprim/sulfamethoxazole, clindamycin, or doxycycline can be given by mouth, but if the infection is severe, vancomycin or linezolid is given by vein.

Cold packs and drugs for pain may relieve discomfort.

Fungal foot infections may be an entry site for infection and may require treatment with antifungal drugs to prevent recurrence.

Compression stockings can be used to lessen swelling caused by erysipelas on a leg.

Drugs Mentioned In This Article

Generic Name Select Brand Names
trimethoprim No US brand name
doxycycline PERIOSTAT, VIBRAMYCIN
clindamycin CLEOCIN
vancomycin VANCOCIN
linezolid ZYVOX

Copyright © 2022 Merck & Co., Inc., known as MSD outside of the US, Kenilworth, New Jersey, USA. All rights reserved. Merck Manual Disclaimer