ABSTRACT
This chapter presents the case study of a 50-year-old woman. A 50-year-old woman presents to the accident and emergency department with a 2-day history of painful facial swelling that was unresponsive to chlorpheniramine. There is a well-demarcated, confluent, livid erythema with oedema and bullae formation, mainly on the left side of her face but spreading to the right. This patient was diagnosed clinically with erysipelas. This is a cutaneous infection, usually caused on the face by group A Streptococcus pyogenes, which may originate from the patient’s throat. The differential diagnosis of sudden-onset facial erythema includes ‘slapped cheek’ or fifth disease, however this usually occurs in children, is symmetrical, and there is little oedema and no blistering. Patients with erysipelas should be managed initially with intravenous antibiotics. This patient was given 1.2 g benzylpenicillin and 2 g flucloxacillin qds for 2 days. The patient was discharged on oral amoxicillin 1 g tds for 2 weeks.
