Erysipelas or St. Anthony's Fire and Aetiology are Painful Skin Infection

Staphylococcus aureus is the leading cause of skin and soft tissue infections, it can cause serious infections such as bloodstream infection, pneumonia or bone infections. Though it can cause infections it is part of the normal human flora it is mostly found on the skin or in nasal cavities. It is a facultative anaerobic gram positive cocci, it is usually in pairs or clusters. The bacterium is also catalase positive, oxidase

BB’s skin presents as pink, warm and dry. No obvious signs or symptoms of abnormal bruising or lesions present however, the patient states that the skin has of late has

HEENT are basically unrevealing. Temp in the office today is 98.4. The outer area of the mouth extending into the chin reveals macules, vesicles, copious purulent exudate forming honey- colored crust on a erythematous base. Skin on trunk, arms and legs is clear. No other symptomology

What are these other serious illnesses that are caused by group A Streptococcus? What is group A Streptococcus? Group A streptococci are bacteria commonly found in the throat and on the skin. The vast majority of GAS infections are relatively mild illnesses, such as strep throat and impetigo. Occasionally, however, these bacteria can cause much more severe and even life threatening diseases such as necrotizing fasciitis (occasionally described as "the flesh-eating bacteria") and streptococcal toxic shock syndrome (STSS). In addition, people may carry group A streptococci in the throat or on the skin and have no symptoms of disease.

Streptococcus pyogenes, also known as Group A streptococcus (GAS), is a β-hemolytic, Gram-positive bacterium that most commonly causes respiratory disease, including pharyngitis or tonsillitis, as well as skin infections such as impetigo and cellulitis. The organism is transmitted via respiratory droplets or by contact with fomites, and commonly infects young children. In addition to the common clinical presentations associated with S. pyogenes, some individuals develop the postinfectious sequelae of rheumatic fever and glomerulonephritis. Due to the severity of these medical consequences, prophylactic antibiotic use is often recommended for any patients with otherwise mild S. pyogenes infections (21).

Streptococcus Pyogenes is a very diverse bacteria with effects ranging from nothing or a mild sore throat, to flesh eating disease, causing death in 40-60% of patients. The major and most common illnesses associated with this bacteria

Initially diagnosis of herpes simplex was entertained and herpes cultures were taken but the appearance of the lesions, the very marked pain that was associated with them, and the occurrence of these lesions in the setting of rheumatoid arthritis and diabetes all suggested a diagnosis of pyoderma gangrenosum. He subsequently, was hospitalized because of worsening respiratory failure and subsequently, was treated for pneumonia and what is probably some congestive failure. He improved from intensive treatment of these problems but developed further ulceration on his right medial thigh with two large undermining lesions. He now is currently being treated with prednisone at 20 mg per day down from previous 40 mg. He continues to have marked hyperglycemia with difficulty controlling his blood sugars partially because of the prednisone dosage. He is being treated now with a collagen wound healing ointment and he is making excellent progress. While hospitalized for his pneumonia and pulmonary decompensation, he was treated with Levaquin and clindamycin. But cultures from the skin lesions were never positive. A biopsy of the lesions has shown a lymphocytic, histocytic and neurophilic infiltrate without signs of

Group A. Streptococcus is a bacterium that causes many different types of infections. It is believed that at least 5-15% percent of the population are carriers of Group A Strep. These carriers tend to carry the bacteria on their skin or in their throats and usually remain asymptomatic.

John is a forty-five year old male who presented in the emergency room experiencing abdominal pain in the right lower quadrant of the ventral cavity. The pain is felt in the umbilical region, right iliac region, and right lumbar region. He is also experiencing pale skin and fatigue. John has a previous history of gastritis(inflammation of the stomach), gastroesophageal reflux disease(stomach acids coming into esophagus), and bradycardia (abnormally slow heart rate). After the laboratory drew blood, the doctor began examining John. Upon his examination, he discovered that John's epidermis was abnormally dry and flaky; this is also known as ichthyosis, proximal to the tibia and fibula. Once the blood work came back, the doctor found the source

There were multiple conditions on the differential, but ultimately a skin biopsy confirmed a diagnosis of Staphylococcal Scalded Skin Syndrome (SSSS). SSSS is a syndrome of acute exfoliation of the skin typically following an erythematous cellulitis. The severity varies from a few blisters localized to the site of infection to a severe exfoliation affecting almost the entire body. SSSS is caused by epidermolytic toxins produced by certain strains (5%) of Staphylococci and is usually seen in neonates and young children. The toxins act at the zona granulosa of the epidermis causing cleavage of desmoglein 1 complex, which is an important protein in desmosomes that anchor keratinocytes to each other. This results in the formation of fragile, tense

aureus is due to several factors. It is coagulase positive which forms accesses and prevents phagocytosis. It produces several exotoxins that create different responses in the body such as exfoliative toxin which causes scalded skin syndrome and enterotoxin which causes Staphylococcal food poisoning. Exotoxins produced by S. aureus are also responsible for Toxic Shock Syndrome, which is associated with tampon use and wound packing. In general, S. aureus is resistant to penicillin and some strains are resistant to methicillin (MRSA). According to the Minnesota Department of Health, most skin infections caused by S. aureus are self-limiting and do not require antibiotic treatment, but in cases where immunity is suppressed or skin is broken due to surgery or injury, infections may require antibiotic treatment or abscess drainage to prevent more serious infection

Necrotizing Fasciitis is a bacterial infection caused by bacteria entering the body through open wounds or sores. There are multiple types of bacteria that can cause Necrotizing Fasciitis but the most common is streptococcus pyogenes also called group A streptococci. Group A streptococcus (GAS) is responsible for over a hundred different types of bacterial infections, ranging from minor illnesses such as strep throat or impetigo to serious illnesses like pneumonia and necrotizing fasciitis (C.D.C). GAS is a facultative gram positive coccus and ß-Hemolytic organism. This rare disease can be caused by more than one type of bacteria. These include Klebsiella, Clostridium, Escherichia coli, streptococcus pyogenes, and Aeromonas hydrophila, among

Also, contraction is very possible through the skin via abrasions both small and large. This type of infection would be contracted from exposure to other people harboring the bacteria, bacteria in the air, or bacteria on the injured person. Being infected this way can rarely result in necrotizing fasciitis. It is also very possible, albeit very rare, that Streptococcus pyogenes can be transmitted through food, most notably milk and its products. This form of infection is usually caused by improper or lack of pasteurization of the milk. The bacteria that are responsible hardly ever come from an outside source, and are usually present within the cow when infected milk is produced. However, these two other methods of transmission are far less likely than the usual human-to-human respiratory infections. (6,2,1)

Onset of Necrotizing fasciitis: At the initial stage of necrotizing infection, the clinical features may present as a typical uncomplicated cellulitis. There may be edema, tenderness and edema in the affected area just as seen in cellulitis. Some of the differentiating features of necrotizing infection which are not common in cellulitis or DVT include, the presence of crepitus as result of subcutaneous gas produced by anaerobic bacteria, edema that spreads beyond erythematous boundary of the infection, lastly, the necrotic area usually has a thin purulent liquid drainage. These features are not seen in this patient hence this diagnosis is ruled

The release of two exotoxins from certain strains of S. aureus can lead to Staphylococcal scaled skin syndrome (SSSS), which is characterized by blistering skin. Invasion into the body can lead to more serious health problems including pneumonia (a frequent complication of influenza), mastitis, phlebitis (inflammation of the veins), meningitis, and urinary tract infections. If the bacterium is allowed to colonize even deeper tissues more serious conditions such as osteomyelitis and endocarditis may result. The most serious consequences of these deeper tissue infections occur when the bacterium invades the bloodstream leading to septic shock and possibly death.