Rose – causes, symptoms and treatment of an infectious disease [WE EXPLAIN]

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Rose – under this name associated with a beautiful flower, there is also a dangerous skin disease that manifests itself in acute inflammation of the skin and subcutaneous tissue. A characteristic feature of rose hips is that the disease progresses rapidly and is accompanied by high fever.

What is a rose?

Rose is an infectious disease that most often affects infants and children under 9 years of age and adults over 60 years of age. Rose is a disease that occurs relatively often in Poland. According to epidemiological data, in 2017 there were 5199 cases of rose disease in Poland.

The first descriptions of rose as a disease date back to antiquity, while the greatest incidence of this disease was in the Middle Ages. At the beginning of the XNUMXth century, the number of rose cases reached epidemic proportions. However, with the introduction of antibiotic therapy in the mid-twentieth century and the improvement of the living conditions of the society, a clear decrease in the incidence of rose was observed.

This ailment is bacterial in nature and affects the skin and subcutaneous tissue. It occurs as a result of infection with group A ß-haemolytic streptococci (Streptococcus pyogenes), although erysipelas have also been reported as a result of Staphylococcus aureus infection.

Symptoms of the disease usually include changes in the deeper layers of the skin and are characterized by painful, inflammatory lesions around the skin of the face and lower limbs. A rose can take a much more severe course when the infection spreads deep into the tissues. Rose is sometimes mistaken by rubella patients, although these diseases do not have much in common. Rubella is a viral disease, not a bacterial disease.

To cause disease, bacteria need special conditions. These include cuts, bites, lymphedema, or changes caused by insufficient blood supply, especially in the legs.

What is streptococcus?

Streptococcus is a gram-positive bacterium that can be both aerobic and anaerobic. Streptococci are microorganisms that cause various diseases, such as pneumonia, pharyngitis and meningitis.

In general, there are several types of streptococci, which are distinguished on the basis of their hemolytic properties: afla hemolysis and beta hemolysis. The streptococcus that causes the rose belongs to the latter group.

What are the complications after infection with streptococcus A? Check: Streptococcus pyogenes – infection, symptoms, treatment, complications

The causes of rose disease

The culprit of trouble is usually streptococci, which penetrate the body as a result of mechanical trauma. The cause of the disease can also be impaired venous or lymphatic circulation, bites, cuts, lymphedema. In such cases, it is referred to as recurrent rose.

It may also happen that the source of the disease is an intracorporeal infection. The disease is most often caused by streptococci belonging to group A, and less frequently by those belonging to group G or C.

Therefore, the risk of erysipelas is increased by the following factors:

1. staphylococcal infection (Staphylococus aureus);
2. group A streptococcal infection;
3. cuts / wounds – as a result of insect bites or surgical procedures and abrasions;
4. impaired venous and lymphatic circulation – especially in the course of deep vein thrombosis, venous insufficiency and after removal of the surrounding lymph nodes; untreated circulatory disorders lead to the formation of ulcers;
5. fungal infections of the feet – make it easier for bacteria to penetrate the body as a result of damage to the skin and a weakened protective barrier;
6. AIDS;
7. previous organ transplants;
8. taking glucocorticosteroids and immunosuppressants;
9. congenital immunodeficiency;
10. leg ulcers due to, for example, circulatory disorders or untreated diabetes; necrosis is an excellent chance for the penetration of microorganisms from the outside.

How to deal with lymphedema? Check: Lymphedema – what happened to your hand?

Does the rose patient infect other people?

Rose is an infectious disease, but infections through direct contact are very rare. What it comes from? Well, rose is a disease that affects much deeper layers of the skin, i.e. the dermis and subcutaneous tissue. In this case, the epidermis becomes a protective barrier against streptococci.

However, it is worth remembering that contact with bladder discharge in the presence of microtraumas can lead to infection.

How is human skin built? Check: The structure of the skin

Rose – the picture of the disease

A rose is an ailment that occurs suddenly. In the beginning, the temperature is high, reaching even 41 degrees Celsius, accompanied by strong chills. In addition, skin lesions are always formed, which consist in the fact that it is severely swollen and reddened.

The lesions are most often located in the area of ​​the lower limbs (shin) and on the face. Sometimes skin changes appear on the feet, hands and buttocks.

The focus of inflammation is clearly separated from the rest of the skin, as if elevated above its surface. It is often irregular in shape. Streaks and red spots appear, which indicates that the infection is spreading through the lymphatic vessels. The skin over the inflamed area is tight, unnaturally smooth and shiny. The patient is significantly weakened during the disease.

Accumulation of exudate fluid in the papillary layer of the skin is a very unpleasant symptom of the disease. When such a process begins, large blisters may appear, which indicate the separation of the epidermis from the rest of the skin. Sometimes there are haemorrhagic changes. In severe cases of erysipelas, tissue necrosis and even gangrene may occur.

In addition to general and skin symptoms, patients have elevated CRP, ESR and leukocytosis. In addition, there are symptoms of ailments that may be the cause of erysipelas, such as swelling of the upper limbs (after removal of the surrounding lymph nodes); pain and swelling in the lower leg after prolonged standing (typical of thrombophlebitis or chronic venous insufficiency); pain in the calves when walking (lower arteriosclerosis); limb ulceration (due to untreated diabetes or atherosclerosis of the lower limbs).

When should a complete blood count should be performed and how should the results of this test be interpreted? Read on: Blood morphology – what is this test, what are the standards?

Different forms of rose

If the disease spreads through the lymphatic vessels, it is called a creeping or wandering rose. Lesions most often appear on the face, and inflammation usually begins in the mucous membranes of the nose or mouth. The creeping rose can also attack the limbs, most often the legs.

The disease is heralded by pain and burning of the skin. The onset of the disease is sudden. Skin changes appear quickly and are easy to observe. There is also high temperature (even above 40 ° C), chills and general breakdown and weakness characteristic of colds or flu.

It is comforting that the skin lesions do not leave any scars. The exception is the gangrenous form of the disease, which is characterized by the formation of gangrene and, consequently, skin necrosis.

A rose can also be:

1. hemorrhagic rose – the characteristic symptoms of erysipelas include hemorrhagic symptoms;
2. blister rose – due to the accumulation of exudate fluid, the epidermis separates and blisters;
3. cancer rose – it is a form of erysipelas, which is formed as a result of tumor metastases along the vessels of the circulatory system; has no characteristic general symptoms;
4. gangrenous rose – it is a severe form of erysipelas and is associated with the formation of areas of necrosis. After suffering from this form of the disease, scars are most often left;
5. relapsing rose – it is a form of the disease that most often causes complications in the form of elephantiasis of the limbs caused by impaired lymph outflow.

The most common complication of erysipelas is its recurrence. Usually the changes appear in the same places where they were before. Unfortunately, when the disease returns, it is remembered for swelling, mainly in the face, genitals or legs. When permanent swelling persists on the legs, the so-called elephantiasis.

Among other complications of erysipelas, specialists mention phlegmon (if purulent lesions were in the subcutaneous tissue) and lymphangitis and venous inflammation.

If you want to know more about elephantiasis, read on: Elephantiasis

How to proceed in case of suspicion of a rose?

If a child or elderly person has symptoms that may indicate erysipelas, see a GP who will assess the patient’s condition and decide on further treatment. Depending on the course of the disease and the presence of other chronic conditions, the doctor may decide to treat at home or refer the patient to hospital treatment.

What does an internist do? Check: internist

Rose and diagnosis

If the changes occur on the legs, the doctor will easily recognize the simple form of the rose. It is enough for him to find an acute inflammation very clearly separated from healthy skin. When making a diagnosis, it is also important to know about the sudden onset and rapid course of the disease, as well as the occurrence of high temperature and chills.

If the lesions are not typical, the physician must determine whether the disease is caused by erysipelas or some other condition. And yes:

1. in thrombophlebitis with a pronounced inflammatory reaction, it differs from erysipelas in that the swelling is less pronounced, the skin is hard and very painful along the entire length of the vein;
2. with acute contact dermatitis, chills and high temperature do not appear;
3. in the case of nodular erythema, numerous bumps are visible on the skin, but there are no general symptoms as dramatic as with rose, i.e. high temperature, severe chills and general breakdown.

When the changes occur in the face and are not specific, you should carefully evaluate what condition you are dealing with:

1. Rose-like symptoms may occur in a person suffering from organ lupus erythematosus, especially after strong sunlight. In such a situation, the doctor must follow the criteria that determine the diagnosis of erythema;
2. skin eruptions can also appear in people suffering from shingles. However, in herpes zoster, the lesions are vesicular, painful, within 1 dermatome, and there is no elevated temperature;
3. erysipelas can also resemble the metastases found on the face and spread through the lymphatic vessels. This is most often the case with metastases from breast cancer. If they are a derivative of neoplastic metastases, there are no general symptoms of erysipelas, i.e. high temperature. The diagnosis is made on the basis of histopathological examinations.

The basis for the diagnosis of erysipelas is a medical interview with the patient and a physical examination. During the medical interview, the patient should describe his ailments very precisely and provide information on past diseases, medications taken, allergy tendencies (if so, which ones), diseases he currently suffers from. A physical examination is also necessary, during which the patient allows the doctor to see every part of the body along with the oral mucosa. During visual inspection, the doctor assesses the nature of the changes – their cohesiveness and hardness; the degree of warmth and the condition of the skin in the area of ​​skin lesions.

In addition, it is reasonable to perform blood tests (complete blood count and ESR), preferably in the morning and on an empty stomach. During the examination, the patient should, above all, be calm. It is important that before collecting the material for testing, he / she does not take any medications or perform intense physical exertion. In people with erysipelas, an increased level of ESR and leukocytosis, which is above 10 cells / ml, can be observed.

Diagnostic tests for ailments that may cause erysipelas:

1. Ultrasound of the lower extremities using the Doppler method;
2. blood lipid testing and blood pressure measurement (should be performed in every patient over 50 years of age);
3. whole blood glucose test (a test important especially for people suffering from diabetes);
4. angiography with angioplasty of the arteries of the lower extremities – a test performed in people suffering from obstructive artery obliteration of the lower extremities;
5. Histopathological examination of the collected material (it is carried out relatively rarely, as the symptoms are usually sufficient to make a proper diagnosis).

What is the histopathological examination? Check: Histopathological examination – should you be afraid?

Rose – treatment

The classic form of erysipelas is treated by giving the patient 7-10 days of antibiotics. Usually these are drugs belonging to semi-synthetic penicillins or one of the cephalosporin generations. If there are other skin problems, e.g. in the form of wounds, it is necessary to make compresses and lubricate the lesions with ichthyol ointment.

During the illness, especially in its initial stage, the patient should rest a lot and also take medications to lower the temperature or eliminate chills. You can use over-the-counter products, but it is better to ask your doctor which preparation is most appropriate. People who are chronically ill and constantly take certain medications should pay special attention to this.

It is worth adding that the treatment of some forms of rose hips can take up to 3 months, when you need to take antibiotics. If the streptococcal strain is resistant to conventional treatment, patients are given a combination of drugs, e.g., amoxicillin with a β-lactamase inhibitor (e.g., clavulanic acid). Storing the rose does not give permanent immunity.

How does the immune system work? Check: How does the immune system work?

Care of a patient with a rose on the lower limb

Proper care of the affected limb reduces the patient’s physical and mental discomfort. Comprehensive care consists primarily in reducing pain by administering appropriate painkillers. Caring for the patient’s health, body temperature should be monitored frequently and the body should be hydrated.

A patient with a lower limb rose must limit his movements or equip himself with instruments that will support his movement. In hospital wards, rollers, walkers, footrests and a Braun splint are available.

If we are dealing with the acute phase of erysipelas, do not use cooling compresses, because they can only hinder the wound healing process. To disinfect the skin, you can use Octenisept, and later Linomag.

For what ailments should I use warm and cold compresses? Check: Warm and cold fun

Can a rose be cured completely?

If an appropriate antibiotic is administered in the course of treatment, usually the patient can count on a complete recovery. Rose is an infectious disease that rarely causes complications, but in its severe course, it requires hospital treatment. Unfortunately, but after an illness, the human body does not become immune to getting sick again, therefore there are known cases of erysipelas recurrence.

Relapses of erysipelas are characteristic because the erythema most often appears in exactly the same places as in the previous course of the disease. Importantly, the treatment of recurrent erysipelas by damaging the lymphatic system often requires even several months of treatment.

What are the causes and symptoms of lymphangitis? Check: Acute lymphangitis

Rose – possible complications

The prognosis for rose is good, however, developing this condition carries a number of complications that significantly affect the patient’s quality of life. Local complications include an increased predisposition to relapse, phlegmon, elephantiasis, and lymphangitis and venous inflammation.

General complications after erysipelas include nephritis, pneumonia, myocarditis, endocarditis and pericarditis. However, sepsis is considered the most serious complication of erysipelas.

What is worth knowing about the causes, symptoms, and complications of pneumonia? Check: Pneumonia

How to prevent rose hips?

The greater the likelihood of developing a rose is the greater the decline in immunity in the patient. This is especially true for the elderly, diabetics and those who are prone to viral and bacterial infections.

If you want to avoid getting sick with rose, you should:

1. systematically control the level of glucose and cholesterol in the blood;
2. quit smoking cigarettes;
3. treat athlete’s foot;
4. take care of the treatment of deep vein thrombosis and chronic venous insufficiency;
5. avoid leg ulcers.

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