- spetrum of streptococci pyogenes infections: - most common cause of celluitis and lymphangitis;
- superficial form of infection is called impetigo which affects stratum corneum;
- ecthyma contagiosum describes shallow superficial dermal ulcers caused by a slightly deeper infectios;
- erysipelas is the term for streptococcal dermal cellulitis, often associated with lymphangitis as it spreads along dermal lymphatics;
- cellulitis can spread to the dermal lymphatics as classical lymphangitis, commonly causeced by strep pyogenes;
- necrotizing streptococal infections: - acute gangrene: at level of fascia, streptococci pyogenes, produces acute gangrene, a form of necrotizing fascitis;
- look for early rapid onset of marked tissue edema and redness w/ little pain, progressing to local
cyanosis & skin blistering;
- lymphangitis and lymphadenopathy are absent;
- soft tissue gas may be uncommon;
- treatment is parental penicillin, debridement, and measures to prevent edema;
- before antibiotics were available this was a surgical emergency mandating immediate amputation to
prevent streptococcal septicemia and death; - group A strep:
- ref: - Group A Streptococcal (GAS) Disease
