Erysipelas: Clinical and Bacteriologic Spectrum and Serological Aspects

The bacteriologic, serological, and clinical characteristics of 229 patients with erysipelas diagnosed during a 2-year period at a university hospital for infectious diseases in Sweden are presented. β-Hemolytic streptococci were detected in 34% of these patients. Group A was the dominant serogroup, but group G streptococci were found in about half as many cases. Bacteremia was present in 5%. A serological response with antistreptolysin O (ASO) and antideoxyribonuclease B (ADNase B) was seen primarily in patients harboring group A streptococci but also in those from whom no pathogen was isolated. ASO was also found in high titers in some patients with group G streptococcal infection. The clinical course was usually benign, with few complications, but recurrences were common (occurring in 21% of the patients). No cases of streptococcal toxic shock were seen. Culture of skin biopsy specimens had low sensitivity; β-hemolytic streptococci were isolated from only two of 15 patients.