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Front Med (Lausanne) 2019 29;6. Epub 2019 Jan 29.

Department of Dermatology, University Clinics, Ludwig-Maximilian University of Munich, Munich, Germany.

Erysipelas is a severe streptococcal infection of the skin primarily spreading through the lymphatic vessels. Penicillin is the treatment of choice. The most common complication consists in relapses which occur in up to 40% or more of patients despite appropriate antibiotic treatment. Read More

BMC Pediatr 2019 Jan 31;19(1):40. Epub 2019 Jan 31.

Department of Pediatric Emergency Department, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.

Objective: Smartphones and associated messaging applications have become the most common means of communication among health care workers and the general population. The aim of this study was to evaluate the reliability and accuracy of smartphones for the diagnosis of rash in children admitted to emergency departments during the night shift.

Methods: The images of the children who were admitted to the paediatric emergency department with rash were included in this study, and at least two images taken with smartphones by residents or paediatric infectious disease fellows were re-directed to the chief consultant of the Paediatric-Infectious Department via smartphone. Read More

Eur J Clin Microbiol Infect Dis 2019 Jan 26. Epub 2019 Jan 26.

Infectiologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France.

Outside areas of S. aureus strains resistant to methicillin (MRSA) in the community, no studies showed a relationship between the treatment for erysipelas or cellulitis and the outcome. We aimed to measure the impact of an internal therapeutic protocol, based on national guidelines on patients' outcome. Read More

Dermatol Online J 2018 Aug 15;24(8). Epub 2018 Aug 15.

Veterans Affairs Medical Center Brooklyn, New York SUNY Downstate, Department of Dermatology, Brooklyn, New York.

Erosio interdigitalis blastomycetica (EIB) is a Candida infection affecting the third web space, between the third and fourth fingers. In 1915, Gougerot and Goncea first described saccharomycetic organisms isolated from the hands and feet. Johannes Fabry later named it in 1917, well before the genus Candida was introduced in 1923. Read More

Prev Vet Med 2019 Jan 29;162:110-116. Epub 2018 Nov 29.

Animal and Human Health Program, International Livestock Research Institute, Hanoi, Vietnam.

Pigs in Lao People's Democratic Republic are important for income and food security, particularly in rural households. The majority of pigs are reared in smallholder systems, which may challenge the implementation of any disease control strategies. To investigate risk factors for pig production diseases in such farming systems in the country a serological survey was conducted during 2011. Read More

Open Forum Infect Dis 2018 Jul 15;5(7):ofy109. Epub 2018 May 15.

Allergan plc, Irvine, California.

Background: The objective of this study was to characterize treatment of patients with acute bacterial skin and skin structure infections (ABSSSIs) and describe the association between hospital admission and emergency department (ED) visits or readmissions within 30 days after initial episode of care (IEC).

Methods: This was a retrospective, observational, cohort study of adults with ABSSSI who presented to an ED between July 1, 2012, and June 30, 2013. Patient, health care facility, and treatment characteristics, including unplanned ED visits or readmissions, were obtained through manual chart review and abstraction. Read More

Clin Neuropathol 2018 Dec 19. Epub 2018 Dec 19.

Dermatol Ther (Heidelb) 2018 Dec 7. Epub 2018 Dec 7.

Department of Dermatology, University of Rzeszow, Rzeszow, Poland.

Introduction: Erysipelas and bacterial cellulitis are two of the most common infectious skin diseases. They are usually caused by the β-hemolytic group of Streptococcus, and less frequently by other bacteria. The objective of the study was to assess the factors affecting the length of stay of patients admitted to hospital with erysipelas or bacterial cellulitis. Read More

Int Med Case Rep J 2018 12;11:313-318. Epub 2018 Nov 12.

Department of Infectious Diseases, Regional Hospital of Bellinzona e Valli, 6500 Bellinzona, Ticino, Switzerland.

Tularemia is a zoonosis caused by the infection of (a gram-negative aerobic bacterium). Transmission to other animals or humans usually occurs through insect or tick bites, direct contact with a contaminated environment (mud or water), infected animals - mainly lagomorphs - or by ingesting undercooked meat or inhaling contaminated dust (hay or soil). This paper discusses the case of a 32-year-old man, who came to our Emergency Room presenting with persistent fever, inguinal lymphadenopathy, and an ulcer on his left lower limb on a linear morphoea lesion that had been there for some time. Read More

Ned Tijdschr Geneeskd 2018 11 19;162. Epub 2018 Nov 19.

Medisch Centrum Leeuwarden, afd. Spoedeisende Hulp.

A 66-year-old patient was seen at the emergency department with a skin infection of the left leg, probably erysipelas, which worsened despite the use of antibiotics. The symptoms had started 5 days earlier. The patient was respiratory and haemodynamically stable, he was not clinically ill and had relatively little pain. Read More

Arthritis Res Ther 2018 Nov 20;20(1):257. Epub 2018 Nov 20.

Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

Background: We showed previously that Japanese individuals with familial Mediterranean fever (FMF) have a more atypical phenotype compared to endemic areas. The clinical differences between young-onset FMF (YOFMF), adult-onset FMF (AOFMF), and late-onset FMF (LOFMF) in Japan are unclear.

Methods: We enrolled 395 consecutive patients. Read More

Vaccine 2018 Dec 13;36(52):8079-8083. Epub 2018 Nov 13.

Animal Infectious Disease Unit, National State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China; College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China; Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture, Wuhan, China; Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China. Electronic address:

Erysipelothrix rhusiopathiae is the causative agent of animal erysipelas and human erysipeloid. Bacterial surface proteins are promising vaccine candidates. We recently identified 3 E. Read More

J Bone Jt Infect 2018 4;3(4):222-225. Epub 2018 Oct 4.

Department of Infectious Diseases, Hospital Universitario de Bellvitge, IDIBELL, Barcelona, Spain.

We describe a case of a 60-year old male who developed an acute prosthetic joint infection (PJI) of the knee, secondary to erysipelas of the lower leg due to beta-hemolytic Group G streptococci. As it is unknown how often this phenomenon occurs in patients with prosthetic implants and which patients are most prone to develop this complication, we analyzed: i) the incidence of the development of a PJI in these patients and ii) the clinical characteristics of streptococcal PJI during an episode of erysipelas/cellulitis. Based on a retrospective analysis of patients with a prosthetic implant presenting at the emergency department with erysipelas/cellulitis, 1 out of 10 patients developed a PJI. Read More

Hong Kong Med J 2018 Dec 9;24(6):593-601. Epub 2018 Nov 9.

Department of Paediatrics, Alberta Children's Hospital, The University of Calgary, Calgary, Alberta, Canada.

Group A β-haemolytic or is a gram-positive coccus that tends to grow in chains. is the cause of many important human diseases, ranging from pharyngitis and mild superficial skin infections to life-threatening systemic diseases. Infections typically begin in the throat or skin. Read More

Orv Hetil 2018 11;159(45):1844-1847

Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083.

Dirofilariasis refers to an infection caused by a specific parasitic roundworm. Dirofilaria repens - transmitted by mosquito bites - accounts for most human cases. The parasite forms a subcutaneous mass called cutaneous dirofilariasis near the original site of intrusion. Read More

Actas Dermosifiliogr 2018 Oct 31. Epub 2018 Oct 31.

Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Cellulitis and erysipelas are local soft tissue infections that occur following the entry of bacteria through a disrupted skin barrier. These infections are relatively common and early diagnosis is essential to treatment success. As dermatologists, we need to be familiar with the clinical presentation, diagnosis, and treatment of these infections. Read More

Zhongguo Zhong Yao Za Zhi 2018 Sep;43(18):3787-3794

School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.

Heat-clearing and detoxifying Chinese herbs (HDCHs) are mainly used to treat carbuncle, sore throat, erysipelas, gills, dysentery and other diseases induced by heat-toxicity. Inflammation is a defensive response to damaging factors in living organism with vascular system. In recent years, a large amount of experimental and clinical studies showed that HDCHs had good therapeutic effect on inflammation. Read More

Vet Microbiol 2018 Nov 18;225:101-104. Epub 2018 Sep 18.

National Institute of Animal Health, National Agriculture and Food Research Organization (NARO), 3-1-5 Kannondai, Tsukuba, Ibaraki, 305-0856, Japan; Research Institute for Biomedical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba, 278-8510, Japan. Electronic address:

Among the four species of the genus Erysipelothrix, Erysipelothrix rhusiopathiae is the main species that causes disease in swine and poultry and has also been isolated from human patients. Recently, E. rhusiopathiae infections in domesticated animals have increased in many countries and are also the cause of emerging wildlife disease in arctic and boreal ecosystems. Read More

Rev Assoc Med Bras (1992) 2018 Jun;64(6):492-497

Medical School of Valença - Rio de Janeiro, RJ, Brasil.

Erysipelatoid Carcinoma (EC), also known as Inflammatory Metastatic Carcinoma, is a rare form of cutaneous metastasis, secondary to an internal malignancy, more often related to breast cancer. Clinically, the lesion has a well-marked, bound erythematous appearance, much like an infectious process, such as erysipelas and cellulitis, these being the most common differential diagnoses. It is characterized by an acute or subacute appearance with an erythematous plaque, sometimes hot and painful, being more often situated in the primary tumor vicinity, especially in the thorax wall in the region of a mastectomy due to breast cancer. Read More

Med Sante Trop 2018 Aug;28(3):273-276

Unité de formation et de recherche en science de la santé. Université Ouaga 1 Joseph Ki-Zerbo (Burkina Faso).

The necrotizing and not necrotizing acute bacterial dermohypodermitis (DHD) are acute bacterial infections of tissues situated between the skin and the muscles. The localizations of the face are infrequent, and sometimes put diagnostic difficulties with other current facial dermatosis. We report in this article 4 cases of DHD of the face with skin source, hospitalized in the service of the Infectious and Tropical Diseases of the Teaching Hospital Yalgado Ouédraogo of Ouagadougou (Burkina Faso). Read More

Med Sante Trop 2018 Aug;28(3):270-272

CHU Sylvanus Olympio, Lomé, Togo.

The aim of this study was to report the frequency of and reasons for dermatology admissions in Lomé (Togo) between 2005 and 2016. This retrospective study examined records from August 2005 to December 2016 from the dermatology departments of the two teaching hospitals in Lomé, Togo. During the study period, 454 (1. Read More

Infect Dis Ther 2018 Dec 21;7(4):509-522. Epub 2018 Sep 21.

MRL, Merck & Co., Inc., Kenilworth, NJ, USA.

Introduction: Injection drug users (IDUs) often develop acute bacterial skin and skin structure infections (ABSSSI) and use emergency departments as their primary source for medical care.

Methods: A post hoc subgroup analysis of two randomized trials examined the efficacy and safety of tedizolid in the treatment of ABSSSI in IDUs. IDUs (n = 389) were identified from two pooled phase 3 trials (NCT01170221, NCT01421511) in patients with ABSSSI (n = 1333). Read More

J Vet Med Sci 2018 Nov 11;80(11):1662-1668. Epub 2018 Sep 11.

Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu 501-1193, Japan.

We investigated possible associations of SLA class II haplotypes with serum antibody titers against a swine erysipelas vaccine, reproductive and meat production traits using a population of selective breeding Duroc pigs. In the selective breeding Duroc pigs, four SLA class II-DRB1 and -DQB1 alleles were assigned by using PCR-sequence specific primer technique. Low-resolution haplotype (Lr)-0. Read More

N Z Vet J 2019 Jan 1;67(1):1-11. Epub 2018 Oct 1.

a Wildbase, School of Veterinary Science , Massey University , Private Bag 11-222, Palmerston North 4442 , New Zealand.

Our knowledge of diseases in New Zealand wildlife has expanded rapidly in the last two decades. Much of this is due to a greater awareness of disease as a cause of mortality in some of our highly threatened species or as a limiting factor to the successful captive rearing of intensely managed species such as hihi (Notiomystis cincta), kiwi (Apteryx spp.) and kakapo (Strigops habroptilus). Read More

IDCases 2018 31;14:e00449. Epub 2018 Aug 31.

Department of Infectious Diseases, St. Luke's International Hospital, Tokyo, Japan.

A clinical case is presented here of a patient with fever and ear pain. Physical examination revealed "Milian's ear sign", which supports the diagnosis of erysipelas rather than cellulitis. After intravenous antibacterial treatment, the patient recovered. Read More

Reumatol Clin 2018 Aug 20. Epub 2018 Aug 20.

Unidad de Reumatología, Hospital del Bierzo, Ponferrada, León, España.

Prim Care 2018 Sep;45(3):433-454

Department of Family Medicine, Tidelands Health MUSC Family Medicine Residency Program, 4320 Holmestown Road, Myrtle Beach, SC 29588, USA.

The primary care provider will commonly see skin and soft tissue infections in the outpatient setting. Skin and soft tissue infections range from the uncomplicated impetigo to the potentially lethal necrotizing fasciitis. This article reviews these infections based on their underlying etiology: bacterial, fungal, and viral causes. Read More

Rheumatology (Oxford) 2018 Dec;57(12):2140-2144

Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

Objectives: FMF is the most frequent monogenic auto-inflammatory disease worldwide. There have been hardly any cases reported in the Chinese population. We aimed to describe the first cohort of adult FMF patients in China. Read More

Hosp Pract (1995) 2018 Aug 21:1-9. Epub 2018 Aug 21.

c Real-World Evidence , Evidera , Waltham , MA , USA.

Objectives: We estimated the total US hospital costs associated with acute bacterial skin and skin structure infection (ABSSSI) admissions as well as the admissions that may have been potential candidates for outpatient parenteral antimicrobial therapy (OPAT).

Methods: We assessed inpatient admissions for ABSSSI from the Premier database (2011-2014), focusing on all admissions of adults with length of stay (LOS) ≥ 1 days and a primary diagnosis of erysipelas, cellulitis/abscess, or wound infection. We performed a detailed analysis of 2014 admissions for patient, treatment, hospital, and economic characteristic variables. Read More

Pan Afr Med J 2018 15;29:153. Epub 2018 Mar 15.

Service des Urgences Médicales Pédiatriques Hôpital d'Enfants, Rabat, Maroc.

We here report the case of a 9-month infant, born to a mother with a history of varicella in the third trimester of pregnancy but with no history of atopy, admitted to the emergency room with painful, pruritic rash in the right hemiface that had been ongoing for 4 days. During physical examination, the infant appeared to be in pain, with multiple cluster of grouped vesicles on erythematous skin in the right hemiforehead, in the right side of the nose and in the right cheek associated with edema of the upper and lower eyelids, with difficulty opening eyes and purulent conjunctival secretions. The infant was afebrile and in a good general condition. Read More

Clin Nucl Med 2018 Oct;43(10):e366-e367

From the Departments of Nuclear Medicine and Molecular Medicine.

A 39-year-old man presented with severe bone pain in the tibiae and forearms in the wake of a poststreptococcal sepsis complicated with pneumonia and erysipelas 4 months earlier. Bone scintigraphy was indicative of periostitis of the tibia, ulna, and radius bilaterally, and in combination with the increased inflammatory parameters and dysproteinemia, the diagnosis of Goldbloom syndrome was made. Goldbloom syndrome is an idiopathic periosteal hyperostosis associated with dysproteinemia and elevated inflammatory parameters. Read More

J Gen Intern Med 2018 Sep 18;33(9):1553-1560. Epub 2018 Jul 18.

Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.

Background: Cellulitis is a common cause of hospitalization. In the USA, the International Classification of Diseases (ICD) code "other cellulitis and abscess" accounts for 1.4% of all admissions and $5. Read More

Case Rep Infect Dis 2018 30;2018:5156085. Epub 2018 May 30.

Division of Infection Medicine, Department for Clinical Sciences Lund, Medical Faculty, Lund University, Lund, Sweden.

The aetiology of erysipelas remains poorly defined though beta-haemolytic streptococci are considered as the main causative pathogens. We describe a case of a 70-year-old woman with recurrent erysipelas in her left arm due to infection with streptococci of the mitis group. Her past medical history includes lymphoedema of the left arm secondary to lymph node dissection due to breast cancer surgery. Read More

Biomed Res Int 2018 11;2018:7670505. Epub 2018 Jun 11.

Biotechnology Process Engineering Center, KRIBB, Cheongju 363-883, Republic of Korea.

The study describes the development of a vaccine using microcrystalline cellulose (Avicel PH-101) as a delivery carrier of recombinant protein-based antigen against erysipelas. Recombinant SpaA, surface protective protein, from a gram-positive pathogen was fused to a cellulose-binding domain (CBD) from endoglucanase II through a S3N10 peptide. The fusion protein (CBD-SpaA) was expressed in and was subsequently bound to Avicel PH-101. Read More

Intern Med J 2019 Feb;49(2):212-216

Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.

Background: Lower leg cellulitis (LLC) is a common infection that is usually caused by Streptococcus pyogenes or other beta-haemolytic streptococci. We hypothesised that in Western Australia (WA), LLC is a summer disease and would be more common in the northern, tropical regions.

Methods: We conducted a statewide data linkage of adult patients presenting to WA hospitals with a first ever diagnosis of LLC, from January 2002 through December 2013 according to the region and season. Read More

J Paediatr Child Health 2018 Dec 26;54(12):1378-1381. Epub 2018 Jun 26.

Paediatric Unit, Santa Chiara Hospital of Trento, Trento, Italy.

Infect Immun 2018 Sep 22;86(9). Epub 2018 Aug 22.

National Institute of Animal Health, Tsukuba, Ibaraki, Japan

causes swine erysipelas, an infection characterized by acute septicemia or chronic endocarditis and polyarthritis. Among 17 serovars, determined based on heat-stable peptidoglycan antigens, serovars 1 and 2 are most commonly associated with the disease; however, the molecular basis for the association between these serovars and virulence is unknown. To search for the genetic region defining serovar 1a (Fujisawa) strain antigenicity, we examined the 15-kb chromosomal region encompassing a putative pathway for polysaccharide biosynthesis, which was previously identified in the Fujisawa strain. Read More

Pan Afr Med J 2018 17;29:41. Epub 2018 Jan 17.

Service des Maladies Infectieuse, CHU Mohamed VI, Université Cadi Ayyad, Marrakech, Maroc.

Introduction: Erysipelas is the most common non necrotizing bacterial dermohypodermitis (NNBDH). This study aimed to evaluate the adequacy of general practitioners' knowledge about literature data on the diagnostic and therapeuthic management of erysipelas.

Methods: We conducted a cross-sectional descriptive and analytical survey of 167 general practitioners in the public and private sectors in Marrakech over the period from 19 May to 20 October 2014. Read More

MMW Fortschr Med 2018 May;160(10):37-40

Sektion Klinische Infektiologie, Med. Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Univ., LMU München, Pettenkoferstr. 8a, D-80336 , München, Deutschland.

PLoS One 2018 30;13(5):e0197291. Epub 2018 May 30.

Centre d'Etudes Biologiques de Chizé, UMR 7372CNRS - Université de La Rochelle, Villiers en Bois, France.

Infectious diseases may be particularly critical for the conservation of endangered species. A striking example is the recurrent outbreaks that have been occurring in seabirds on Amsterdam Island for the past 30 years, threatening populations of three Endangered seabird species and of the endemic, Critically Endangered Amsterdam albatross Diomedea amsterdamensis. The bacteria Pasteurella multocida (avian cholera causative agent), and to a lesser extent Erysipelothrix rhusiopathiae (erysipelas causative agent), were both suspected to be responsible for these epidemics. Read More

NPJ Vaccines 2018 18;3:17. Epub 2018 May 18.

2Translational Immunology, Department of Biomedicine, University Basel Hospital, Basel, Switzerland.

Pneumococcal conjugate vaccine (PCV) is recommended for adults with chronic disease. Extensive limb swelling (ELS) is an acute vigorous local inflammatory reaction following vaccination. Predisposing immune system correlates and the influence of ELS on vaccine responses are not known. Read More

Asian-Australas J Anim Sci 2018 Nov 25;31(11):1818-1827. Epub 2018 Apr 25.

Departamento de Anatomía y Anatomía Patológica Comparadas, Facultad de Veterinaria, Universidad de Murcia, Espinardo, Murcia 30100, Spain.

Objective: The objective of this work was to determine the prevalence of the pathologies that caused the condemnation of pig carcasses in an area of intensive pig farming and Mediterranean climatology and to evaluate their influence in a risk-based inspection procedure for slaughterhouses.

Methods: A retrospective observational investigation was carried out from 2002 to 2016 into the pathological processes that caused the condemnation of pig carcasses in a slaughterhouse from South-eastern Spain. The seasonal effect on the causes of condemnation carcass was reported. Read More

Case Rep Orthop 2018 5;2018:7236372. Epub 2018 Mar 5.

Cardiovascular Surgery Department, The Medicine School in São José do Rio Preto (FAMERP) and CNPq (National Council for Research and Development), São Jose do Rio Preto, SP, Brazil.

Objective: The present study was aimed at evaluating the use of mechanical and manual lymphatic therapy as a treatment for lymphedema resulting from orthopedic surgery that became painful after an episode of erysipelas.

Case Report: A 70-year-old male patient suffered direct trauma resulting in a compound fracture of the tibia and fibula of the left leg. He was treated with an external fixator for four months followed by plaster cast immobilization for three weeks. Read More

Ugeskr Laeger 2018 Apr;180(15)

This is a case report of a 56-year-old man, who presented with a very rare cause of erysipelas and bacteraemia caused by the Gram-negative bacillus Shewanella algae. To our knowledge, this is the first reported case of imported Shewanella-infection in Denmark. The patient, who had a history of liver cirrhosis, returned home from a one-month vacation in Thailand. Read More

G Ital Dermatol Venereol 2018 Apr 19. Epub 2018 Apr 19.

Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

Background: Skin biopsy is an important tool for various skin conditions. However, in the case of leg ulcers, some Authors still consider it highly risky and mandatory only in selected cases.

Methods: To evaluate the rate of adverse events after leg ulcers biopsy in 866 consecutive patients referring to our Wound Care Unit in Bologna from January 2008 to December 2016. Read More

Int J Surg Case Rep 2018 10;46:31-33. Epub 2018 Apr 10.

Department of Plastic and Reconstructive Surgery, University of Bari, Italy.

Introduction: Secondary lymphedema is the most frequent long-term complication of axillary lymphadenectomy. It can result in complication as erysipelas, warts, Papilloma Cutis Lymphostatica (PCL), or angiosarcomas. Moreover, in women affected by breast cancer an accurate differential diagnosis among these conditions or complication related to radiation dermatitis or cutaneous metastasis is essential. Read More

J Dermatol 2018 Oct 14;45(10):e272-e274. Epub 2018 Apr 14.

Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Acta Dermatovenerol Alp Pannonica Adriat 2018 03;27(1):1-4

Centre for Communicable Diseases, National Institute of Public Health, Ljubljana, Slovenia.

Introduction: Erysipelas is a common infection of the skin and subcutaneous tissue. Despite the relative frequency of erysipelas, data on its basic epidemiological characteristics are scant. This study describes the trends in erysipelas epidemiology in Slovenia. Read More

Chin Med J (Engl) 2018 Apr;131(7):873-874

Department of Emergency Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.