Sinus Infection (Sinusitis)

Sinusitis is an inflammation of the tissues in your sinuses (spaces in your forehead, cheeks and nose usually filled with air). It causes facial pain, a stuffy or runny nose, and sometimes a fever and other symptoms. It’s usually caused by the common cold, but other viruses, bacteria, fungi and allergies can also cause sinusitis.

 

Overview

Illustration showing inflamed, fluid-filled sinuses. Common pain or pressure points are in your forehead, cheeks and nose.

Sinusitis is an inflammation of your sinuses. It can cause facial pain and a stuffy or runny nose with thick mucus.

 

What is sinusitis (sinus infection)?

Sinusitis is an inflammation, or swelling, of the tissue lining your sinuses. Sinuses are structures inside your face that are normally filled with air. Bacterial infections, viral infections and allergies can irritate them, causing them to get blocked and filled with fluid. This can cause pressure and pain in your face, nasal congestion (a stuffy nose) and other symptoms.

Sinusitis is also sometimes called rhinosinusitis.

 

What are sinuses?

Your sinuses are four paired cavities (spaces) in your head. Narrow passages connect them. Sinuses make mucus that drains out of the passages in your nose. This drainage helps keep your nose clean and free of bacteria, allergens and other germs (pathogens).

 

Types of sinusitis

We describe types of sinusitis based on how long it’s been going on (acute, subacute, chronic or recurrent) and what’s causing it (bacteria, virus or fungus).

 

Acute, subacute, chronic and recurrent sinusitis

-Acute sinusitis symptoms (nasal congestion, drainage, facial pain/pressure and decreased sense of smell) last less than four weeks. It’s usually caused by viruses like the common cold.

-Subacute sinusitis symptoms last four to 12 weeks.

-Chronic sinusitis symptoms last at least 12 weeks. Bacteria are usually the cause.

-Recurrent acute sinusitis symptoms come back four or more times in one year and last less than two weeks each time.

 

Bacterial and viral sinusitis

Viruses, like the ones that cause the common cold, cause most cases of sinusitis. Bacteria can cause sinusitis, or they can infect you after a case of viral sinusitis. If you have a runny nose, stuffy nose and facial pain that don’t go away after ten days, you might have bacterial sinusitis. Your symptoms may seem to improve but then return and are worse than the initial symptoms. Antibiotics and decongestants usually work well on bacterial sinusitis.

 

Fungal sinusitis

Sinus infections caused by fungus are usually more serious than other forms of sinusitis. They’re more likely to happen if you have a weakened immune system.

 

How do I know if I have sinusitis, COVID, a cold or an allergy?

Colds, COVID-19, allergies and sinus infections all have similar symptoms. It can be difficult to tell them apart. The common cold typically builds, peaks and slowly disappears. It lasts a few days to a week. Nasal allergies cause sneezing, itchy nose and eyes, congestion, runny nose and postnasal drip (mucus in your throat). They usually don’t cause the facial pain that sinus infections do. COVID-19 can cause additional symptoms, like fever and shortness of breath.

A cold, COVID or allergies can all cause sinus infections. You can test yourself or have a provider test you for some viral infections, like COVID-19 and the flu.

 

Symptoms and Causes

What are the signs and symptoms of sinusitis?

Common symptoms of a sinus infection include:

-Postnasal drip (mucus dripping down your throat).

-Runny nose with thick yellow or green mucus.

-Stuffy nose.

-Facial pressure (particularly around your nose, eyes and forehead). This might get worse when you move your head around or bend over.

-Pressure or pain in your teeth.

-Ear pressure or pain.

-Fever.

-Bad breath (halitosis) or a bad taste in your mouth.

-Cough.

-Headache.

-Tiredness.

 

What causes sinus infections?

Viruses, bacteria, fungi and allergens can cause sinusitis. Specific triggers for sinusitis include:

 

-The common cold.

-The flu (influenza).

-Streptococcus pneumoniae bacteria.

-Haemophilus influenza bacteria.

-Moraxella catarrhalis bacteria.

-Nasal and seasonal allergies.

 

What are the risk factors for sinusitis?

Some people are more likely to get sinusitis than others. Risk factors include:

 

-Nasal allergies.

-Asthma.

-Nasal polyps (growths).

-Deviated septum. Your septum is a line of tissue that divides your nose. A deviated septum isn’t straight, narrowing the passage on one side of your nose. This can cause a blockage.

-A weakened immune system. This can be from illnesses like HIV or cancer, or from certain medications.

Smoking.

 

Is sinusitis contagious?

Sinusitis itself isn’t contagious. But the viruses and bacteria that can cause it are. Remember to follow good handwashing practices, avoid other people if you’re sick and sneeze or cough into your elbow.

 

What happens if sinusitis is left untreated?

You don’t necessarily need to treat sinusitis — it often goes away on its own. Very rarely, untreated sinus infections can lead to life-threatening infections. This happens if bacteria or fungi spread to your brain, eyes or nearby bone.

 

Diagnosis and Tests

How is a sinus infection diagnosed?

Healthcare providers diagnose sinusitis based on your symptoms and health history. A provider will check your ears, nose and throat for swelling, draining or blockage. They might use an endoscope (a small, lighted instrument) to look inside your nose.

 

A primary care provider may also refer you to a specialist, like an otolaryngologist (also called an ENT — an ear, nose and throat specialist).

 

Specific tests to diagnose sinusitis

Specific tests your provider might order to diagnose sinus infection include:

 

Nasal endoscopy.

-Nasal swabs. Your provider may use a soft-tipped stick to get a fluid sample from your nose. They’ll test it for viruses or other germs that might be causing your symptoms.

-Imaging. In some cases, your provider might order a computed tomography (CT) scan to better understand what’s happening inside your sinuses.

-Allergy testing. If you have chronic sinusitis, your provider may test you for allergies that could be triggering it.

-Biopsy. Rarely, a provider may take a tissue sample from your nose for testing.

 

Management and Treatment

How is sinusitis treated?

There are many treatment options for sinusitis, depending on your symptoms and how long you’ve had them. You can treat a sinus infection at home with:

 

-Decongestants.

-Over-the-counter (OTC) cold and allergy medications.

-Nasal saline rinses.

-Drinking plenty of fluids.

-If symptoms of sinusitis don’t improve after 10 days, a provider may prescribe:

 

Antibiotics.

-Oral or topical decongestants.

Prescription intranasal steroid sprays. (Don’t use nonprescription sprays or drops for longer than three to five days — they may actually increase congestion.)

Providers treat chronic sinusitis by focusing on the underlying condition. Treatments can include:

 

-Intranasal steroid sprays.

-Topical antihistamine sprays or oral pills.

-Leukotriene antagonists, like montelukast.

-Surgery to treat structural issues, polyps or fungal infections.

 

What are the best medications for a sinus infection?

If you need an antibiotic, which one your provider prescribes depends on your specific situation. Some options include:

 

-Augmentin (amoxicillin/clavulanate).

-Amoxicillin.

-Doxycycline.

-Levofloxacin.

-Cefixime.

-Cefpodoxime.

-Clindamycin.

 

Are complementary and alternative therapies useful for treating sinusitis?

You might find acupressure, acupuncture or facial massage helpful in reducing symptoms of sinusitis, including draining, pressure and pain. Ask a provider if these therapies might help in your specific case.

 

Do I need antibiotics for every sinus infection?

No. Providers often wait to see how long your symptoms last before prescribing antibiotics. Many sinus infections are caused by viruses. You can’t cure viral infections with antibiotics. Overusing antibiotics or using them to treat viral infections can lead to unnecessary side effects or antibiotic resistance. This may make future infections harder to treat.

 

Outlook / Prognosis

What can I expect if I have sinusitis?

Sinusitis usually only lasts a week to 10 days. You can usually treat it with over-the-counter medicines and at-home treatments. If you have chronic sinusitis or if it keeps coming back, there may be underlying causes that you’ll need to treat.

 

Prevention

Can sinusitis be prevented?

Depending on the cause, there are a few ways to reduce your risk of getting sinus infections, including:

 

-Rinsing your nose with saline (salt water) as directed by your provider.

-Taking steps to prevent allergies. This includes medications, allergy shots and avoiding your known allergy triggers (like dust, pollen or smoke).

-Using steroid nasal sprays if your provider recommends them.

-Establishing good handwashing and other habits that reduce your risk of getting sick with infectious diseases.

-Avoiding smoke. There are ways to help you quit smoking, if you do.

-Living With

 

When should you see a doctor for a sinus infection?

You can usually care for sinus conditions on your own. But if you continue to have symptoms that concern you or if you get infections repeatedly, talk to a healthcare provider. They can help you understand your next steps.

 

When should I go to the ER?

Go to the nearest emergency room or seek medical attention right away if you experience symptoms of a serious infection, including:

 

-High fever (over 103 degrees Fahrenheit/40 degrees Celsius).

-Confusion or other mental changes.

-Vision changes, especially if you have pain or swelling around your eyes.

-Seizures.

-Stiff neck.

 

https://my.clevelandclinic.org/health/diseases/17701-sinusitis

 

Herpes zoster: Causes, Symptoms, Treatments

 

Shingles can be a difficult and very painful condition for the patient. In our country and on our island we have encountered many cases of shingles and especially due to the high temperatures, the herpes spreads very quickly and the pain is almost unbearable. When a patient presents any rash and especially painful or itchy it would be good to immediately visit our medical unit for immediate diagnosis and treatment.

 

Herpes zoster, or shingles, is a viral infection caused by the reactivation of a dormant VZV quiescent in the sensory ganglia of people who have had chickenpox. When a person recovers from chickenpox.

 

 

Herpes Zoster (Shingles) 

Herpes zoster, or shingles, is a viral infection caused by the reactivation of a dormant VZV quiescent in the sensory ganglia of people who have had chickenpox. When a person recovers from chickenpox, the VZV remains dormant in the nerve ganglia. However, when body immunity weakens, the latent VZV reactivates, resulting in herpes zoster symptoms including itching, burning pain, and a flare-up stripe of red rashes along the sensory nerve ganglia, followed by eruption of clear blisters that may be associated with a fever. If left untreated, herpes zoster can cause complications such as herpes zoster ophthalmicus, postherpetic neuralgia (PHN), and neurological problems. Those who suspect they have herpes zoster should seek medical attention as soon as possible for appropriate treatment and antiviral drugs.

What causes herpes zoster (shingles)? 

Herpes zoster, or shingles, is caused by the reactivation of the varicella-zoster virus (VZV), which causes chickenpox when first infected. Once recovered, the VZV remains dormant in the sensory ganglia for decades without causing symptoms. As the body's immunity deteriorates, the latent VZV reactivates by dividing, multiplying, and spreading along the nerve distribution of a sensory ganglion, resulting in nerve inflammation, pain along the sensory nerve, and a stripe of red rash on the skin, followed by clear fluid-filled blisters distributed in band-like distribution along the length of the sensory nerves, causing itching, burning pain, sharp neuropathic pain, headaches, and may be associated with fever. Everyone who has ever had chickenpox is at risk of developing herpes zoster.

Who is at risk for herpes zoster? 

•    Those aged 50 years and up

•    Those with low body immunity

•    Those who take immune-suppressing medications.

•    HIV-infected individuals

•    Those who have cancer.

•    Bedridden patients

•    Those under stress

•    Those who do not get enough sleep.

•    Those who have suffered multiple traumas.

•    Those who have received an organ transplant.

•    Those who are undergoing chemotherapy.

•    Those who have used steroids for a prolonged period.

•    Those suffering from chronic diseases such as diabetes, autoimmune diseases, SLE, heart disease, or kidney disease.

What are the symptoms of herpes zoster/shingles?

 

Herpes zoster/shingles symptoms are classified into 3 stages:

Pre-eruptive phase

The pre-eruptive phase (or preherpetic neuralgia stage) occurs when the latent VZV spreads through the sensory ganglion through the sensory nerves, resulting in nerve inflammation, peripheral neuropathy, numbness, acute pain, and burning pain on one side (unilateral) of the skin along the sensory nerve distribution of the ganglion, as well as itching, body aches, and headache. In some cases, there may be associated symptoms such as fever, fatigue, diarrhea, or light sensitivity (photophobia). During the pre-eruptive phase, symptoms typically last 1-3 days. However, there will be no skin lesions.

Acute eruptive phase

The acute eruptive phase occurs when red skin rashes appear along the sensory nerve distribution of a sensory ganglion, followed by eruptions of clear fluid-filled blisters (vesicles), typically on the left or right half of the body as well as the back or legs, or on one side of the face, eyes, or neck. Unlike the chickenpox rash, the herpes zoster rash typically does not disperse as widely throughout the body and will fully develop within 3-5 days. Those with a herpes zoster infection rash will experience a headache, fever, fatigue, and exquisite pain along the skin innervated by the sensory nerves with light contact or simply touching by the clothing. Over 10–15 days, the rashes will break and become sores, then gradually dry, scab over, and eventually fall off the skin. In those with normal body immunity, herpes zoster rash typically appears on one side of the body (unilateral). Conversely, rashes are more likely to be severe, formed on both sides of the body in those with low immunity, cancer, AIDS, or those receiving chemotherapy.

Chronic phase:

The chronic phase (or postherpetic neuralgia: PHN) occurs after the herpes zoster rash has subsided and the skin lesions along the sensory nerve distribution have faded. However, most people with herpes zoster will continue to experience some symptoms, such as burning pain, tingling sensations, or acute pain along the nerve that ranges from moderate to severe. Pain may be constant or come and go. In some cases, pain may persist for decades.

Zoster Sine Herpete (ZSH):

Some people with herpes zoster may experience zoster sine herpete (ZSH) or herpetic neuralgia without a rash. There may be numbness, itching, and burning pain along the nerves, but no rash appears on the skin. Anyone who suspects they have zoster sine herpes should seek medical attention promptly for further diagnosis.

How is herpes zoster diagnosed?

Doctors will diagnose herpes zoster by taking a history and performing a physical examination to look for herpes zoster lesions by examining for the skin rashes or blisters to see if they are dispersed widely or appear in clusters along one side of the body with symptoms of itching, burning pain, or fever. In cases where no lesions are visible or there is a suspicion of zoster sine herpete (ZSH), the doctor will employ the following methods to perform additional diagnostic tests for herpes zoster:

Tzanck smear: The Tzanck smear involves puncturing the blisters, scraping off a sample of tissue for cells from their bases, placing the sample on a glass slide, leaving it dry, and sending it to the laboratory for Wright-Giemsa staining to examine cell characteristics under a microscope. The Tzanck smear is considered a quick and simple test, but it may be unable to distinguish between herpes simplex and herpes zoster rash.

Viral culture entails taking a sample of vesicle cells and culturing them in a VZV viral growth media. The accuracy of the test ranges between 60 and 90%.

Polymerase chain reaction (PCR) is an immunological test that looks for specific genetic elements of the suspected herpes zoster virus. The PCR test has high sensitivity and specificity, 2-3 times more accurate than the viral culture method.

How is herpes zoster treated?

The doctor will treat herpes zoster to decrease the disease severity and the burning pain, prevent complications, and assist the patient in recovering from the disease as quickly as possible. The doctor will consider herpes zoster treatment and medications based on the duration of the disease and detected symptoms. However, the most effective treatment for herpes zoster is to begin treatment within 48-72 hours after the rash appears. Herpes zoster treatments include the following:

Antiviral drugs: Doctors may prescribe antiviral drugs such as Acyclovir, Famciclovir, or Valaciclovir to reduce the severity of the disease, inflammation, and virus spread in the skin, as well as reduce burning pain, accelerate blister subsidence, minimize the risk of recurrence, promote a quick recovery, and reduce the risk of complications associated with herpes zoster.

Antibacterial drugs: The doctor may consider anti-inflammatory agent prednisolone and antibiotics, both oral and topical, for people with herpes zoster who have secondary bacterial infections to reduce inflammation, pain, and hasten herpes zoster rash clearance, particularly those with zoster sine herpete or herpes zoster rash flare up on any part of the face.

Pain reliever: In cases of severe pain, the doctor may opt to combine antiviral drugs with pain medications like paracetamol or NSAIDs such as ibuprofen to expedite pain relief 

What is the complication of herpes zoster (shingles)? 

Postherpetic neuralgia (PHN) 5-30% of herpes zoster patients aged 50 and older will experience persistent neuropathic pain for more than three months after the disappearance of skin rashes. The severity of the symptoms correlates with age. Seniors will experience more severe and prolonged symptoms than younger people. In some instances, pain can persist for a lifetime, leading to issues such as insomnia, limited mobility, nerve-related pain, weakness, or being able to move an affected limb only slightly.

Herpes zoster ophthalmicus/Ocular shingles, is a herpes zoster complication in which the herpes zoster rash flares up in the eyes, causing eye irritation, inflammation, corneal ulcers, or retinal inflammation, blurred vision, sensitivity to light (photophobia), or cataracts. In severe cases, ocular shingles can result in blindness, Ramsay-Hunt syndrome, or facial hemiplegia. Those experiencing ocular shingles should seek medical attention promptly to avoid further complications.

Neurological problems: Herpes zoster can cause neurological issues such as facial paralysis, hearing loss, and balance problems.

Bacterial skin infections: If not kept clean, a bacterial skin infection can complicate an episode of herpes zoster, causing delayed healing, persistence of rash, redness, and scarring.

Severe pain: For those with low body immunity, HIV, or cancer patients receiving chemotherapy, when they have herpes zoster, the pain is likely to be more severe and can transmit the disease to others more easily.

Stroke: Cerebral artery occlusion, and cerebral hemorrhage (found in those suffering from severe chronic pain).

Pneumonia and encephalitis are rare complications of herpes zoster. 

Is the myth “if the herpes zoster wraps around the body, you will die” true? 

The myth “if the herpes zoster wraps around the body, you will die” is untrue. In some cases, herpes zoster rash can develop simultaneously on the left and right sides of the body, eventually giving the appearance that it is wrapping around your body and seeming to constrict you to die. In fact, most people who die from herpes zoster are secondary to their low body immunity, leading to complications associated with herpes zoster infection, which later weaken their bodies and eventually cause death. Therefore, patients 50 or older and those with low immunity are more likely to contract it.

How to manage herpes zoster at home?

See a doctor right away to receive an antiviral drug within 48–72 hours of the onset of sharp pain or burning pain associated with fever.

Take oral and apply tropical medicine strictly as prescribed by the doctor to help reduce the severity of the disease, lesions, and complications.

Apply a cold compress with gel and cover the rash loosely.

Avoid using herbal medicines, inhalers, or other medications obtained without a doctor's prescription for the herpes zoster rash or itchy rash, as they may cause complications from a bacterial infection, slowing wound healing and possibly leaving a scar.

Avoid scratching a herpes zoster or itchy rash. If your nails are long, trim them short to reduce bacteria buildup, which can lead to complications and recurrent bacterial infections.

Cover an open wound to prevent bacterial infection.

Always wash your hands thoroughly and keep your hands clean regularly.

Wear loose, clothing to prevent skin from rubbing against clothing.

What are the preventions for herpes zoster/shingles?

Herpes zoster vaccine: Those who have or have not previously had chickenpox as a child, those aged 50 years and older, those with low body immunity, and all those at high risk of herpes zoster can prevent herpes zoster by receiving vaccination against the disease.

Avoid direct contact with high-risk people: Those with herpes zoster should avoid direct contact with high-risk people to prevent the virus from spreading to others, such as the elderly, those who have never had chickenpox, those with weakened immune systems, young children, or pregnant women. Furthermore, personal belongings including bedding, clothes, and clothing of individuals with herpes zoster should be kept separate from others.

Maintain a healthy body: Eating all five food groups, exercising regularly, keeping your mind stress-free and relaxed, and getting enough rest will help your immune system remain strong and keep you away from herpes zoster. 

Herpes zoster vaccine 

With current medical advancements, the Herpes Zoster Vaccine was developed and designed to be more effective in preventing and reducing herpes zoster complications. There are 2 types of herpes zoster vaccines available in Thailand.

Zoster vaccine live (ZVL) is a live attenuated vaccine. The recommended dosage is 1 dose. ZVL is a vaccine that is 69.8% effective in preventing herpes zoster in people aged 50–59 years.

Shingrix vaccine, a recombinant subunit zoster vaccine (RZV), is a new type of herpes zoster vaccine requiring a series of 2 shots. Shingrix is a protein sub-unit vaccine made of glycoprotein E, a VZV component providing effective prevention for herpes zoster.

Instructions for administering the new Herpes Zoster Vaccine: Shingrix vaccine.

Adults over 50: Give 2 RZV injections, space 2–6 months apart.

Anyone 18 with a weakened immune system due to disease or treatment: Give 2 RZV injections 1-2 months apart. 

Shingrix vaccine is 97% effective in preventing herpes zoster in people over 50. It is 68-91% effective in preventing herpes zoster in immunocompromised people aged 18 and older, up to 91.2% effective in preventing postherpetic neuralgia (PHN), and up to 89% effective in preventing herpes zoster as long as 10 years after vaccination.

How long does herpes zoster last? 

Typically, from the pre-eruptive phase to the chronic phase, herpes zoster resolves within 3-5 weeks. However, individuals who have received antiviral medication within 72 hours of the onset of symptoms may recover from herpes zoster within 2 weeks.

Herpes Zoster, a Vaccine-Preventable Viral Infection

Individuals who have previously contracted chickenpox are susceptible to herpes zoster, particularly as they age, experience declining health, or a reduction in natural immunity. Herpes zoster can lead to severe pain, complications, and detrimental effects on quality of life. Those encountering symptoms of herpes zoster should promptly seek medical assistance to obtain suitable treatment for a speedy recovery.

Herpes zoster is preventable with vaccination, adequate rest, eating nutritious foods, and exercising regularly to keep the body strong and maintain robust natural immunity. Individuals over 50, those with weakened immune systems, and individuals at high risk for herpes zoster are advisable to receive the herpes zoster vaccine at a hospital. Prompt herpes zoster vaccination can help prevent herpes zoster and its complications in the long run, as well as promote long-term good health.

FAQ

What are the initial symptoms of herpes zoster/shingles?

The first symptoms of herpes zoster/shingles encompass itching, sharp pain, tingling, and a burning sensation within 1-3 days before the appearance of clusters of red rashes in the skin innervated by sensory nerves of a ganglion, followed by the appearance of clear fluid-filled blisters that gradually break off and subside within 10-15 days. In addition, some people may experience fever, chills, and headaches, while others may later experience neuropathic pain.

What is the difference between herpes zoster and herpes simplex?

Both herpes zoster and herpes simplex are caused by infection with the human herpesvirus (HHV), which belongs to the same herpesvirus family but differs in the type of virus and the nature of the lesions. Herpes zoster is due to the VZV virus, which causes clear, fluid-filled blisters along the skin innervated by sensory nerves, whereas herpes simplex is due to HSV-1 or HSV-2 virus, which causes clear, fluid-filled blisters on the mouth or genital areas

Is herpes zoster/shingles contagious?

Herpes zoster/shingles can be transmitted from person to person who has never had chickenpox by inhaling droplets containing viruses generated by coughing, sneezing, or direct contact with blisters or lymph from sores on the skin in those with acute herpes zoster. Therefore, herpes zoster patients should be isolated from high-risk groups such as those with weakened immune systems, the elderly, young children, or pregnant women to reduce the risk of possible cross-infection.

Which foods should be avoided during herpes zoster?

Patients with herpes zoster should refrain from eating the following foods

High glycemic carbohydrate foods, e.g., white flour, bakery goods, cakes, desserts, candies, and syrups.

Foods high in saturated fat, such as fast food and fatty meat.

Foods high in arginine such as red meat, poultry, dried beans, and chocolate.

Ultra-processed foods, such as processed meats, butter, margarine, and ice cream

Alcoholic beverages such as liquor, beer, and wine

Can herpes zoster go away on its own?

Herpes zoster may heal and go away on its own in those with strong immunity. However, if not treated properly by a doctor, untreated herpes zoster can lead to complications such as postherpetic neuralgia (PHN), neurological problems, etc.

What is the difference between herpes zoster and chickenpox?

Herpes zoster and chickenpox differ in the appearance of the rash. Herpes zoster rash typically clusters in a band and does not spread throughout the body as does chickenpox rash. Typically, the rash of herpes zoster appears only along the skin distribution of sensory nerves of a ganglion, in which the varicella-zoster virus lies dormant previously. It starts out as a red rash and progresses to a swollen, clear, fluid-filled blister that eventually breaks off and scabs over. Herpes zoster rashes are prevalent on the waistline or ribcage, back, legs, and either side of the face, eyes, or neck. Herpes zoster symptoms are frequently more severe than chickenpox and can lead to complications if left untreated.

 

 ( https://www.medparkhospital.com/ja-JP/disease-and-treatment/herpes-zoster-shingles )

 

 

Welcome to the new Quick MED Clinic

 

CONTACT 

 

DOCTOR   0030 6974 139 931

 

SECRETARY  0030 6972681581

 

CLINIC  0030 22450 23032 

 

People have been asking us, how we feel about our new Clinic. And we answer that it may not have been our decision to leave the old Clinic, but we feel the new energy, the new momentum and the fresh air... and as you know we are always ready. You can trust us. Try us. With great joy we would like to introduce you to our new Clinic. Do not forget that our Clinic is also your Clinic because without your contribution nothing would be possible. We thank you very much for everything.

Health, medical treatment and care on the island of Karpathos

Emergency and regular incidents in Karpathos are very common on our island. 

There is no problem, however, when it is well known that there is the HIPPOCRATES QUICK MED CLINIC, which is open for you all day, every day, even on holidays. 

With a simple phone call to the clinic (0030 22450 23 0 32) or to the Secretariat (0030 6972 681 581) or directly to the Doctor (0030 6974 139 931) your problem is solved immediately.  

The doctor can visit you directly at your Hotel or you can come directly to the Clinic without an appointment, because the clinic is a WALK IN CLINIC.

The entire medical team is ready to welcome you and do the best for you at any time of the day. Dr. Socrates will take care of you by doing whatever is necessary to address your health problem. Don't hesitate... just call him on the phone or call the Clinic... it's that simple. 

Erysipelas

What is erysipelas?

Erysipelas is a superficial form of cellulitis, a potentially serious bacterial infection affecting the skin.

Erysipelas affects the upper dermis and extends into the superficial cutaneous lymphatics. It is also known as St Anthony's fire due to the intense rash associated with it.

Who gets erysipelas?

Erysipelas most often affects infants and older people but can affect any age group. Risk factors are similar to those for other forms of cellulitis. They may include:

-Previous episode(s) of erysipelas

-Breaks in the skin barrier due to insect bites, ulcers and chronic skin conditions such as psoriasis, athlete’s foot and eczema

-Current or prior injury (eg, trauma, surgical wounds, radiotherapy)

-In newborns, exposure of the umbilical cord and vaccination site injury

-Nasopharyngeal infection

-Venous disease (eg, gravitational eczema, leg ulceration) and lymphoedema

-Immune deficiency or compromise, such as

-Diabetes

-Alcoholism

-Obesity

-Human immunodeficiency virus (HIV)

-Nephrotic syndrome

-Pregnancy.

 

What causes erysipelas?

Unlike cellulitis, almost all erysipelas is caused by Group A beta-haemolytic streptococci (Streptococcus pyogenes). Staphylococcus aureus, including methicillin-resistant strains (MRSA), Streptococcus pneumoniae, Klebsiella pneumoniae, Yersinia enterocolitica, and Haemophilus influenzae have also been found rarely to cause erysipelas.

 

What are the clinical features of erysipelas?

Symptoms and signs of erysipelas are usually abrupt in onset and often accompanied by fevers, chills and shivering.

Erysipelas predominantly affects the skin of the lower limbs, but when it involves the face, it can have a characteristic butterfly distribution on the cheeks and across the bridge of the nose.

-The affected skin has a very sharp, raised border.

-It is bright red, firm and swollen. It may be finely dimpled (like an orange skin).

-It may be blistered, and in severe cases may become necrotic.

-Bleeding into the skin may cause purpura.

-Cellulitis does not usually exhibit such marked swelling but shares other features with erysipelas, such as pain and increased warmth of affected skin.

-In infants, it often occurs in the umbilicus or diaper/napkin region.

-Bullous erysipelas can be due to streptococcal infection or co-infection with Staphylococcus aureus (including MRSA).

 

What are the complications of erysipelas?

Erysipelas recurs in up to one-third of patients due to:

-Persistence of risk factors

-Lymphatic damage (hence impaired drainage of toxins).

-Complications are rare but can include:

-Abscess

-Gangrene

-Thrombophlebitis

-Chronic leg swelling

-Infections distant to the site of erysipelas

-Infective endocarditis (heart valves)

-Septic arthritis

-Bursitis

-Tendonitis

-Post-streptococcal glomerulonephritis (a kidney condition affecting children)

-Cavernous sinus

-thrombosis (dangerous blood clots that can spread to the brain)

-Streptococcal toxic shock syndrome (rare).

 

How is erysipelas diagnosed?

Erysipelas is usually diagnosed by the characteristic rash. The differential of erysipelas is similar to the cellulitis mimics. There is often a history of a relevant injury. Tests may reveal:

-Raised white cell count

-Raised C-reactive protein

-Positive blood culture identifying the organism.

-MRI and CT are undertaken in case of deep infection.

 

What is the treatment for erysipelas?

General

•Cold packs and analgesics to relieve local discomfort

•Elevation of an infected limb to reduce local swelling

•Compression stockings

•Wound care with saline dressings that are frequently changed.

Antibiotics

•Oral or intravenous penicillin is the antibiotic of first choice.

•Erythromycin, roxithromycin or pristinamycin may be used in patients with penicillin allergy.

•Vancomycin is used for facial erysipelas caused by MRSA

•Treatment is usually for 10–14 days

 

What is the outlook for erysipelas?

While signs of general illness resolve within a day or two, the skin changes may take some weeks to resolve completely. No scarring occurs.

Long term preventive treatment with penicillin is often required for recurrent attacks of erysipelas.

Erysipelas recurs in up to one-third of patients due to the persistence of risk factors and also because erysipelas itself can cause lymphatic damage (hence impaired drainage of toxins) in involved skin which predisposes to further attacks.

If patients have recurrent attacks, long term preventive treatment with penicillin may be considered.