Skin inflammatory (nontumor)
Infectious disorders

Author: Ha Kirsten Do, M.D. (see Authors page)

Revised: 18 October 2018, last major update July 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Erysipelothrix [title]

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Cite this page: Do, H.K. Erysipelothrix. website. Accessed February 21st, 2019.
Definition / general
  • A rare disease, with ~ 50 articles published from 1950 - 2008
  • Erysipelothrix rhusiopathiae, formerly named Erysipelothrix insidiosa, is a rod-shaped, nonmotile, gram-positive bacteria that forms long-branching filaments with characteristic hyaline granules
  • Bacteria are present on dead animal skin, more frequently swine
  • Previously called Rosenbach disease, Baker-Rosenbach disease and pseudoerysipelas
  • Erysipeloid is an occupational infection caused by traumatic penetration of skin by Erysipelothrix rhusiopathiae
  • Causes cutaneous disease in humans who work with animals or fish
Clinical features
  • Two clinical varities of erysipeloid exist: a more common localized cutaneous form and a rare generalized variety
  • 2 - 7 day incubation period
  • According to some authors, serotypes 2, 7 and 16 are most commonly involved in human erysipeloid
  • Clinical diagnosis is based on patient occupation history, history of traumatic skin contact with infected meat and classic erythematous, edematous skin lesions of back of hands / fingers with well defined and raised borders
  • Causes cutaneous erysipeloid and rarely septicemia, with endocarditis of aortic and mitral valves
  • Insidious onset over months
  • May also cause botryomycosis, a pseudomycosis

  • Description:
    • Marginated or polygonal thin plaques of purplish painful swelling on the back of the hands and fingers
    • Condition is migratory, with new purplish red patches appearing at nearby sites and centrifugally
    • Rarely severe swelling of fingers, termed whale finger or seal finger
Case reports
  • 54 year old black man with fatal endocarditis, no skin lesions, no history of animal / fish exposure (Hum Pathol 2005;36:117)
  • Most mild cases of erysipeloid run a self limited course of about 3 weeks
  • Recurrent eruptions can be treated with Penicillin; use ciprofloxacin, clindamycin and imipenem if penicillin allergy
  • Use IV penicillin up to 6 weeks for severe systemic form
  • Bacteria is resistant to Vancomycin (important for endocarditis cases)
Clinical images

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Various images

Microscopic (histologic) description
  • Slender or filamentous gram positive rod similar to actinomycetes
  • Often nonspecific histopathology
  • Dermoepidermal detachment with many neutrophils floating in the blisters
  • Upper and mid-dermis is edematous with vascular dilatation; infiltrate consists mainly of neutrophils and lymphocytes with some eosinophils
Electron microscopy images

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