title: Complicated Skin and Skin Structure Infection After Erysipelas: Urgent Need for Antibiosis and Surgery.
abstract: Erysipelas are common soft tissue infections responding to first-line antibiosis. Because of factors of related to responsible bacteria and host, complications can occur that need extensive surgery in addition to intensified drug therapy. We report on a 65-year-old woman with leg ulcer who developed an absceding and necrotizing panniculitis of the affected leg complicating erysipelas. Escherichia coli and Pseudomonas aeruginosa were identified. Debridement and surgical removal of inflamed subcutaneous adipose tissue was decisive to interrupt the process. Wound bed preparation was realized by vacuum-assisted closure. Final wound closure was done by split-skin mesh graft. Complicated skin and skin structure infections need a combined approach of intensified antibiosis and surgery to save life.
authors.affiliation: Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany wollina-uw@khdf.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.affiliation: Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Dana
authors.initials: D
authors.lastname: Langner
authors.affiliation: Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Heinig
authors.affiliation: Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Schönlebe
authors.affiliation: Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nowak
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D062109:Dermatologic Surgical Procedures; D004886:Erysipelas / Q000150:complications*; D004927:Escherichia coli Infections / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D015434:Panniculitis / Q000209:etiology* / Q000628:therapy*; D017192:Skin Diseases, Bacterial / Q000209:etiology* / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: complicated skin and skin structure infection; erysipelas; panniculitis; surgery; vacuum-assisted closure therapy