Cellulitis vs. Erysipelas?

[Doctor4Life1769]

Probably will sound trivial to you guys, but it's a legit question. How do you distinguish between the two? I know Cellulitis is mostly S. aureus and #2 being GAS ... erysipelas being mostly due to GAS. However, if you did not have that information, how do you distinguish between the two? I know erysipelas has raised, well-demarcated borders, however, I am also reading that cellulitis can also present with a similar presentation. So, for the purposes of recognition in the clinic and also on a board-question style format, how do you distinguish between the two?

Thanks!

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[TMP-SMX]

Erysipelas is a more superficial infection of the dermis compared to cellulitis. You are correct that it is more typically GABHS and more sharply demarcated border. Cellulitis and erysipelas often coexist.

 

[Doctor4Life1769]

Thanks for the reply!

 

[TMP-SMX]

No problem. Also, make sure you don't use my namesake as the drug of choice. No strep coverage.

 

[MsMacey]

you may be able to elicit a recent history of strep throat and then the erysipelas infection usually occurs on the face

 

[Doctor4Life1769]

TMP-

Thanks again for the tips - especially the s/p strep infection leading to the facial erysipelas - money.