Erysipeloid cutaneous leishmaniasis: a study of 40 cases of an unusual variant.

BACKGROUND: Erysipeloid cutaneous leishmaniasis (ECL) is known as the chronic form of cutaneous leishmaniasis (CL). However, keeping its clinical presentation in view, there is a need to revisit this form of the disease. AIMS: To describe ECL in view of clinical features and treatment modalities. METHODS: We include a case series seen in Sfax (Southern Tunisia) from January 2017 to January 2021. All patients clinically suggestive and laboratory confirmed with a diagnosis of CL were registered. Patients of all age groups and of either gender having cutaneous lesions resembling erysipela on the face were included in the study. Different demographic features of the patients and clinical aspects were identified. Descriptive statistics were used for analysis. RESULTS: Of 1300 registered patients with CL, 40 (3%) were diagnosed as ECL. Ages ranged from 15 to 65 years, and duration of lesions varied from 15 to 180 days. All patients had lesions over the face. Clinically, a painful infiltrated inflammatory placard of the central facial area with a butterfly shape was observed in 14 cases, as well as zones of the cheekbone (11 cases), cheekbone and nose (5 cases), cheekbone and eyelid (8 cases), and cheekbone with ear (2 cases). Several therapeutic methods were prescribed with a sufficient result with no recurrence. CONCLUSION: ECL is a rare presentation that typically occurs on the face, looking like erysipelas, in patients who are native from an endemic region of CL.

Erysipelatoid Carcinoma.

Erysipelatoid Carcinoma (EC), also known as Inflammatory Metastatic Carcinoma, is a rare form of cutaneous metastasis, secondary to an internal malignancy, more often related to breast cancer. Clinically, the lesion has a well-marked, bound erythematous appearance, much like an infectious process, such as erysipelas and cellulitis, these being the most common differential diagnoses. It is characterized by an acute or subacute appearance with an erythematous plaque, sometimes hot and painful, being more often situated in the primary tumor vicinity, especially in the thorax wall in the region of a mastectomy due to breast cancer. Here we present the case of a 75-year-old patient with ductal infiltrated carcinoma for 3 years, who presented an acute erythematous and infiltrated plaque in the region of a previous mastectomy, with a final diagnosis of EC.

Erysipelatoid Carcinoma

SUMMARY Erysipelatoid Carcinoma (EC), also known as Inflammatory Metastatic Carcinoma, is a rare form of cutaneous metastasis, secondary to an internal malignancy, more often related to breast cancer. Clinically, the lesion has a well-marked, bound erythematous appearance, much like an infectious process, such as erysipelas and cellulitis, these being the most common differential diagnoses. It is characterized by an acute or subacute appearance with an erythematous plaque, sometimes hot and painful, being more often situated in the primary tumor vicinity, especially in the thorax wall in the region of a mastectomy due to breast cancer. Here we present the case of a 75-year-old patient with ductal infiltrated carcinoma for 3 years, who presented an acute erythematous and infiltrated plaque in the region of a previous mastectomy, with a final diagnosis of EC.

Empyema in spinal canal in thoracic region, abscesses in paravertebral space, spondylitis: in clinical course of zoonosis Erysipelothrix rhusiopathiae.

OBJECTIVES: Erysipelas is an animal disease caused by Gram-positive bacteria Erysipelothrix rhusiopathiae. Among the domestic animals, domestic pig (Sus scrofa f. domestica) suffers most frequently from the disease in human environment. This is a typical animal-borne disease observed mainly in occupational groups employed in agriculture, farming (of animals and birds), fishing and manufacturing industry. METHODS: We are presenting the clinical course of infection (E. rhusiopathiae) and discuss clinical forms. E. rhusiopathiae in humans may have the following clinical course: mild form of skin infection diagnosed as local erythema (erysipeloid), disseminated form of skin infection and the most serious form of infection of systemic course (endocarditis and sepsis). Mild skin infection and local erythema are the most common forms. Very rare case of animal-borne infection course has been presented in which after initial phase the disease was generalised to the abscesses formation in paravertebral space, spondylitis and empyema formation in spinal canal. In the presented clinical case, the patient was suffering from diabetes. It was probably an additional risk factor of the disease generalisation. Patient underwent drainage of empyema in spinal canal, after which his neurological status gradually improved. Antibiotic therapy was implemented and continued for 8 weeks. Such course of erysipelas was not previously described in the literature. RESULTS: After therapy neurological status was improved. In follow MRI control exam empyema and spondylitis was successfully eliminated. CONCLUSIONS: Various complications of the disease, such as endocarditis and heart valves disturbances, are well known and are the most severe complications of the generalised infection. Proper targeted and long-term antibiotic therapy is crucial.

Unusual form of cutaneous leishmaniasis: erysipeloid form.

UNLABELLED: We report the epidemiological and clinical characteristics of the erysipeloid form of cutaneous leishmaniasis as well as its diagnostic and therapeutic challenges. CASE REPORT: A 63-year-old woman, with no medical history, presented with a one-month history of erythematous nasal swelling. The lesion appeared after an accidental trauma. Erythematous infiltrative plaque was noted on the center of the face. There were also crust formations on the traumatic region. Despite local treatment and oral antibiotherapy, there was no improvement. The diagnosis of cutaneous leishmaniasis was confirmed by positive skin smears. Histopathological examinations of a skin biopsy showed no malignancy. The patient was treated intramuscularly with 10mg/kg per day systemic meglumine antimoniate with partial regression of symptoms. CONCLUSION: The erysipeloid type is a rare and unusual presentation of cutaneous leishmaniasis that often causes late diagnosis. Diagnosis is confirmed by the demonstration of the parasite by skin smear, histopathological examination and polymerase chain reaction. There are various therapeutic options. The evolution is generally favourable.

[Mitral valve endocarditis after Turkish "Festival of Sacrifice"]. / Mitralklappenendokarditis nach türkischem Opferfest.

Erysipelothrix rhusiopathiae is the causative agent of swine erysipelas. Systemic infections caused by E. rhusiopathiae are rare, but often (90%) associated with endocarditis. In about 60% of cases endocarditis develops on normal heart valves, and despite appropriate antibiotic therapy about one-third of the patients requires valve replacement. We report the case of a housewife, who developed a mitral valve endocarditis due to E. rhusiopathiae after preparing meat for the Turkish "Festival of Sacrifice".

Erysipeloid--case report.

Erysipeloid is an acute, bacterial infection of traumatized skin in an individual who was in direct contact with meat or other animal products contaminated with a gram-positive bacillus Erysipelothrix rhusiopathiae. We present a case of a 50-year-old housewife whose hobby was fishing, with a reddish, tender patch on the fifth finger and dorsum of the left hand, which developed a week after she had sustained an injury while boning the fish. The patient was treated with orally administered penicillin V 1,500,000 IU t.i.d. for 7 days, with complete resolution.

[Differential diagnosis of Lyme borreliosis]. / Die wichtigsten Differenzialdiagnosen: Wanderröte oder Arzneimittelexanthem--Neuroborreliose oder MS?

In all three stages, Lyme borreliosis offers a wide range of possible differential diagnoses: even the "typical" erythema chronicum migrans may present as erysipelas, erysipeloid, erythema annulare centrifugum or a drug-induced exanthema. In the advanced stages II and III, neuroborreliosis in particular may be mimicked by various other conditions of both infectious and noninfectious etiology. Major examples are CEE (Central European Encephalitis), ehrlichiosis, chlamydial infections and multiple sclerosis. Currently, the biggest diagnostic problem is the non-standardized laboratory diagnostic work-up. For this reason, even in the presence of a positive or borderline IgG antibody result, unclear symptoms should prompt a differential diagnostic investigation.