Last update:
06-Feb-2008

The case is reported of a patient suffering from erysipelas on the right hemithorax. The rareness of its localization and the history of external trauma led to the initial mistaken diagnosis of contusion and inflammation of the soft tissues. A 65 year-old man was admitted to the Larissa University Hospital Emergency Department with pain over the right lateral chest wall. He reported indirect blunt injury to that site three days earlier. There was tenderness in the affected area; the skin was reddened with no visible dermatolysis. He was febrile (temperature of up to 39 °C). From the clinical evaluation, a post-traumatic "phlegmon" was suspected (soft tissue contusion, bruising, edema, inflammation, secondary microbial colonization). On the second day of admission, the correct infective etiology was suspected estimating the features of the skin lesion, and including high fever and marked leucocytosis. Εrysipelas was considered a possible diagnosis. The clinical data, the dermatological examination, the almost typical course of the disease, the improvement of patient's status and the final cure following administration of the appropriate antibiotics confirmed erysipelas. The patient was discharged from hospital on the seventh day. Erysipelas does not have a predilection for the skin of the thoracic wall, but clinicians should consider it when dealing with thoracic cutaneous lesions characterized by erythema and inflammation.

Key words: Cellulites, Erysipelas, Group A Streptococcus, Streptococcus pyogenes.