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.

[Occupational causes of erysipeloid morbidity among the workers engaged in meat-processing industry in the Lugansk region]. / Professional'naia zabolevaemost' erizipeloidom rabochikh miasopererabatyvaiushchei promyshlennosti Luganskoi oblasti.

Erysipeloid takes the second place after eczema among other occupational diseases at the meat-processing enterprises of Lugansk region. The maximal occurrence is seen at the meat enterprises in summer. The morbidity is promoted by slight traumatism in cold and humid work conditions. Skin and joints are most frequently affected by the disease. One of each four among the sufferers demonstrates the prolonged course with longstanding arthropathies.

Erysipelas in caged laying chickens and suspected erysipeloid in animal caretakers.

Erysipelas was diagnosed in 2 succeeding caged layer flocks housed in the same building and was characterized clinically by sudden death. At necropsy, lesions comprised generalized congestion, hemorrhages in the skeletal muscles and visceral organs, and swelling of liver, spleen, and kidney with or without large irregular zones of necrosis. Focal to massive hepatic necrosis was seen histologically with minimal or no inflammatory reaction. Erysipelothrix rhusiopathiae was cultured from internal organs of affected birds in both outbreaks. Medication with penicillin in the feed controlled the mortality, but relapse occurred after cessation of medication. Two attendants who handled the dead birds in this building developed a painful localized infection of the fingers that later spread to the regional lymph node. The infection responded when antibiotic therapy for erysipeloid was initiated.

Erysipelothrix rhusiopathiae: an occupational pathogen.

Erysipelothrix rhusiopathiae is a nonsporulating, gram-positive, rod-shaped bacterium which was identified more than 100 years ago as the etiologic agent of swine erysipelas. Since then, it has been found to cause infection in several dozen species of mammals and other animals. Humans become infected through exposure to infected or contaminated animals or animal products. By far the most common type of human infection is a localized, self-limited cutaneous lesion, erysipeloid. Diffuse cutaneous and systemic infections occur rarely. Approximately 50 cases of endocarditis have been reported; all but one recent case have involved native valves. The organism may be isolated from biopsy or blood specimens on standard culture media. It is identified by morphology, lack of motility, and biochemical characteristics; identification may be confirmed by the mouse protection test. It is susceptible to penicillins, cephalosporins, erythromycin, and clindamycin, but it is often resistant to many other antibiotics, including vancomycin, a drug frequently used in empiric therapy for infections due to gram-positive bacteria.

[Erysipeloid as an occupational disease of workers in shoe enterprises]. / Erizipeloid kak professional'noe zabolevanie rabochikh obuvnykh predpriiatii.

An outbreak of erysipeloid among the workers of a shoe factory is described. The spread of infection occurred due to contact with infected raw materials, which was confirmed by the isolation of Erysipelotrix rhusiopathiae from washings made from chrome and Russia leather supplied by different tanneries, as well as from casein glue. The raw materials could be additionally infected by rodents, in particular by common voles; the above-mentioned infective agent had been repeatedly isolated from these animals on the territory of this region. Leather was also infected in the process of soaking: the infective agent was isolated from the water of soaking baths. For the first time the routes of the spread of erysipeloid infection among shoe factory workers were bacteriologically confirmed. The recommended complex of sanitary, medical and antiepidemic measures led to the liquidation of the outbreak and thus proved to be effective. The authors draw the attention of epidemiologists, sanitary inspectors, occupational pathologists and heads of medical centers at shoe factories to the necessity of preventing the spread of occupational erysipeloid infection among the workers, as well as to the necessity for dermatologists, surgeons and infectionists, most frequently dealing with erysipeloid patients, to be correctly oriented in respect to this infection.

[On the dermal form of erysipeloid in slaughter house workmen (author's transl)]. / Erysipeloid bei Schlachthofarbeitern.

We described the incidence and clinical course of the dermal form of erysipeloid in 125 workmen of a central slaughter-house in Bukarest. The highest frequency of the illness was observed in summer and autumn (83 cases), especially in the group aged 21 to 50 years (96 cases). Most of the cases of erysipeloid are occupationally acquired by various persons engaged in handling meat, often butchers and workmen in meat, skin, and bone processing factories. The most frequent localisation of the process was at the index fingers and thumbs of both hands.

[Erysipeloid on the islands of the Sea of Okhotsk. I. The sources and vectors of the causative agent of erysipeloid]. / Ob érizipeloide na ostrovakh Okhotskogo moria. Soobshchenie I. Istochniki i perenoschiki vozbuditelia érizipeloida

The foci of the causative agent of erysipeloid at the islands of the Okhotsk sea were of the polyvector and polyhostal character. There were recorded 92 species of the naturally infected by the erysipeloid causative agent invertebrate inhabitants of the sea, fish, amphibia, reptilia, birds, mammals and ectoparasites of the warm-blooded animals. Gamazoid and ixodes ticks, mosquitoes, horse-flies and flees were found to be naturally infected with erysipelotrix. Ixodes persulcatus were found to be capable of infecting albino mice during blood sucking.

[The student, the cetacean and swine-fever. A minor epidemic after dissection of a globicephale]. / L'étudiant, le cétacé et le rouget. Une petite épidémie d'érysipéloïde après dépeçage d'un globicéphale

A whale (Globicephalus melas), stranded on the north coast of Finistere, was the origin of a minor epidemic of Baker-Rosenbach erysipeloid. The clinical picture was that usually seen after contamination by marine animals (spiny fish, crabs, molluscs). To our knowledge, this is the first time that a marine mammal has been found to be infected by Erysipelothrix rhusiopathiae.