Erysipelas: evolution under treatment, complications.

Objective The authors studied the evolution and the complications of lower limb erysipelas under antibiotherapy. Method. The following parameters were studied in literature over the last 2 0 years (keyword - erysipelas): percentage of favorable course, delay for c ure, local or systemic: complications, prognostic factors, and mortality. Results. Data was only available in series of hospitalized patients. The fe wer limbs were the exclusive or the most frequently involved areas. Under s ystemic antibiotherapy, the overall efficacy rates reached 76-84 p. 100, wi th apyrexia within 24 to 48 h, and regression of local symptoms within 4 to 6 days. The median hospital stay was 10-13 days. A longer hospital stay wa s observed for: older patients, associated diseases, longer duration of ill ness prior to admission, and presence of a leg ulcer. Complications were ob served: abscess or superficial necrosis (3-12 p. 100), deep thrombophlebiti s in 1.4 p. 100 of retrospective studies vs. 2.6.15 p. 100 in prospective s eries. Mortality was low (0.5 p. 100) due to systemic complications more th an to the severity of local symptoms. Relapse was frequent (15-25 p. 100) Discussion. The unavailability of data concerning outpatients limits the fo rmulation of valid conclusions. Nevertheless the medical course was favorab le (80 p. 100) with apyrexia within 2 days, and absence of local symptoms w ithin 4 to 6 days. Mortality or longer duration of hospital stay was linked to age or to associated diseases. The risk of deep thrombophlebitis was ra re in absence of predisposing Factors. Systematic prevention should be sugg ested sind care given to local predisposing factors responsible for frequen t recurrent forms.