Overview
Erysipelas is a superficial form of cellulitis, characterized by a sharply demarcated, raised, erythematous rash, most commonly affecting the lower extremities and face. While typically not exclusive to the postpartum period, it can occur in this demographic.Diagnosis
Diagnosis is primarily clinical, based on the characteristic appearance of the rash 1.
Key features include a sudden onset of fever, chills, and malaise, followed by the development of a raised, erythematous, and tender plaque with well-defined borders 1.
Cultures of wound exudate or blood may be obtained, particularly in severe cases or when treatment failure occurs 1.Management
First-line treatment involves antibiotics, typically penicillin or cephalexin 1.
For patients allergic to penicillin, alternative options include erythromycin, clindamycin, or trimethoprim-sulfamethoxazole 1.
Treatment duration is usually 5 to 10 days, depending on clinical response 1.
Supportive care includes elevation of the affected limb, cool compresses, and analgesics for pain and fever 1.Special Populations
Postpartum women are susceptible to erysipelas, as with the general population 1.Key Recommendations
Antibiotic therapy, such as penicillin or cephalexin, is recommended for the treatment of erysipelas 1. (Evidence: Moderate)
For patients with penicillin allergy, alternative antibiotics like erythromycin, clindamycin, or trimethoprim-sulfamethoxazole should be considered 1. (Evidence: Moderate)
Supportive measures including limb elevation and analgesics are important adjuncts to antibiotic therapy 1. (Evidence: Moderate)References
1 Beamish NF, Davenport MH, Ali MU, Gervais MJ, Sjwed TN, Bains G et al.. Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. British journal of sports medicine 2025. link