Erysipelas and phlegmon are bacterial infections of the skin and underlying tissue that can quickly become serious if not treated in time. Both conditions are typically caused by streptococci or staphylococci, bacteria that can enter the body through small cuts, wounds, or cracks in the skin. While they may start as localized redness or swelling, these infections can spread rapidly, requiring prompt medical evaluation.
What Is Erysipelas?
Erysipelas, often referred to as “St. Anthony’s fire,” is an acute bacterial skin infection that primarily affects the upper layers of the skin. It usually appears as a sharply defined, bright red patch that is warm, swollen, and painful to the touch. The affected area often spreads quickly, accompanied by systemic symptoms such as fever, chills, and fatigue.
The face and legs are the most common sites for erysipelas. Risk factors include weakened immunity, chronic skin conditions, lymphedema, or untreated wounds.
What Is Phlegmon?
Phlegmon differs from erysipelas in that it involves deeper layers of tissue, including subcutaneous fat and connective tissue. Unlike erysipelas, the affected area is not always sharply defined. Instead, it may present with diffuse redness, severe swelling, pain, and sometimes pus formation. Patients often experience fever, general malaise, and rapid worsening of symptoms.
Because phlegmon spreads through deeper tissue, it carries a higher risk of complications, including sepsis if untreated.
Common Causes and Risk Factors
Both erysipelas and phlegmon occur when bacteria penetrate damaged skin. Risk factors include:
- Open wounds, surgical scars, or insect bites
- Fungal infections between the toes that break the skin barrier
- Circulatory disorders or chronic venous insufficiency
- Diabetes mellitus, which impairs immune response and wound healing
- Weak immune system due to illness or medication
Symptoms to Recognize
Erysipelas is typically characterized by:
- Bright red, shiny skin patches with clear borders
- Swelling and pain in the affected area
- Fever, chills, and enlarged lymph nodes
Phlegmon often presents with:
- Widespread, poorly defined redness and swelling
- Severe pain and warmth in the affected tissue
- Fever, fatigue, and in some cases pus formation
- Potential spread to muscles and bloodstream
Diagnosis
Doctors usually diagnose these infections based on clinical appearance and patient history. Laboratory tests may show elevated inflammatory markers. In severe cases, blood cultures may be taken to detect bacteria in the bloodstream. Imaging, such as ultrasound or MRI, can help assess how deeply the infection has spread.
Treatment Options
- Antibiotics: The cornerstone of therapy for both conditions. They may be given orally in mild cases or intravenously in severe infections.
- Bed rest and elevation: Particularly when the legs are affected, to reduce swelling and promote healing.
- Pain management: Medications to control discomfort and fever.
- Surgical intervention: In phlegmon with abscess formation, drainage or debridement may be necessary.
Early treatment is crucial to prevent serious complications such as sepsis, chronic swelling, or recurrent infections.
Preventive Measures
- Treat minor skin injuries immediately with proper cleansing and disinfection.
- Manage chronic conditions such as diabetes or circulatory problems.
- Keep skin moisturized to prevent cracks and fissures.
- Wear protective footwear to avoid injuries, especially for individuals with neuropathy.
- Seek medical attention for recurring redness, swelling, or wounds that do not heal properly.
With more than 37 years of experience, Erdem Hospital offers expert care for bacterial skin and soft tissue infections like erysipelas and phlegmon, ensuring accurate diagnosis, effective treatment, and prevention of recurrence.
Frequently Asked Questions
- What is the difference between erysipelas and phlegmon?
Erysipelas affects the upper layers of the skin and has sharply defined borders, while phlegmon spreads through deeper tissues with diffuse redness and swelling. - Are these infections contagious?
While the bacteria themselves are contagious, erysipelas and phlegmon usually occur when bacteria enter through broken skin. They are not spread through casual contact. - How quickly do symptoms appear after infection?
Symptoms of erysipelas often develop suddenly within hours to days, while phlegmon can progress rapidly once bacteria penetrate deeper tissues. - Can erysipelas or phlegmon return after treatment?
Yes. People with circulatory problems, lymphedema, or untreated skin conditions have a higher risk of recurrence. Preventive care is important. - What complications can occur if left untreated?
Both conditions can lead to blood poisoning (sepsis), chronic swelling, tissue damage, or life-threatening infections if not treated promptly.