Excerpt from Erysipeloid

Synonyms, Key Words, and Related Terms: Erysipelothrix rhusiopathiae (insidiosa), E rhusiopathiae, infected meat, erysipeloid of Rosenbach, skin lesions, endocarditis

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Background

Erysipeloid is an acute bacterial infection of traumatized skin and other organs. It is caused by the microorganism Erysipelothrix rhusiopathiae (insidiosa), which long has been known to cause animal and human infections. Direct contact between meat infected with E rhusiopathiae and traumatized human skin results in erysipeloid. In animals, the organism causes swine erysipelas and several other diseases in poultry and sheep.

Erysipeloid is an occupational disease. Humans acquire the infection after direct contact with infected animals. The disease is more common among farmers, butchers, cooks, homemakers, and anglers. The infection is more likely to occur during the summer or early fall.

Pathophysiology

E rhusiopathiae, which is highly resistant to environmental factors, enters the skin through scratches or pricks. In the skin, the organism is capable of producing certain enzymes that help it dissect its way through the tissues. It has recently been discovered that only pathogenic strains of E rhusiopathiae are capable of producing the neuraminidase enzyme. This enzyme is speculated to help the microorganism invade tissues. Moreover, 2 adhesive surface proteins were discovered and their nucleotide sequence encoded. The proteins are named RspA and RspB and serve in helping the microorganism bind to biotic (collagen types I and IV) and abiotic (polystyrene) surfaces.

Meanwhile, the host's immune system is activated to start fighting against this foreign bacterium. The organism may escape immune surveillance and may spread in the body via the vascular system to the joints, heart, brain, CNS, and lungs. The organ most commonly affected other than the skin is the heart.

Frequency

International

Infection with E rhusiopathiae occurs in worldwide distribution in a variety of animals, especially hogs.

Mortality/Morbidity

Erysipeloid usually is an acute, self-limited infection of the skin that resolves without consequences. Individuals with the systemic form, in which organs other than the skin are involved, may have neurologic, cardiologic, or other impairments. Individuals with systemic infection may even die of sepsis, if the proper diagnosis is not made, and treatment is not initiated early on.

Race

No racial predilection is recognized.

Sex

Both sexes may be equally affected; however, the disease seems to affect more males than females because of occupational exposure.

Age

Erysipeloid can affect any age group.

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