{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T09:11:50Z","timestamp":1709889110332},"reference-count":0,"publisher":"National Institute of Public Health NIH (National Research Institute)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Przegl Epidemiol"],"abstract":"<p><strong>ABSTRACT<\/strong><br \/><strong>INTRODUCTION.<\/strong> Erysipelas is an acute inflammation of skin and subcutaneous tissue. Erythema nodosum is\u00a0the most frequent form of panniculitis considered as a reaction to different factors, most commonly infections,\u00a0especially streptococcal.<br \/><strong>CASE PRESENTATION.<\/strong>\u00a0A 74-year-old male presented to hospital due to skin lesions involving the same\u00a0area he was bitten by an adder six months earlier. On the admission well-demarcated erythema and oedema on\u00a0the right shin with accompanying fever were noted. Erysipelas was diagnosed and intravenous ceftriaxone was\u00a0administered. Two days later a few tender nodules within that unilateral location appeared. Based on the clinical\u00a0and histopathological picture diagnosis of B\u00e4vferstedt subtype (erythema nodusum migrans, ENM) was made.\u00a0The treatment was continued, further followed by doxycycline orally resulting in clinical improvement.<br \/><strong>CONCLUSIONS.<\/strong> This case presents an unusual coexistence of erysipelas and erythema nodosum migrans,\u00a0the more it was observed on the primary adder bite area and occurred in a man. Most probably, adder\u2019s venom\u00a0could lead to disturbed blood and lymph flow what predisposed to erysipelas, which, as streptococcal infection,\u00a0could trigger ENM.<\/p>\n<p><strong>STRESZCZENIE<\/strong><br \/><strong>WST\u0118P.<\/strong> R\u00f3\u017ca to ostry stan zapalny sk\u00f3ry i tkanki podsk\u00f3rnej. Rumie\u0144 guzowaty jest najcz\u0119stsz\u0105 form\u0105 zapalenia\u00a0tkanki podsk\u00f3rnej uwa\u017can\u0105 za reakcj\u0119 w odpowiedzi na r\u00f3\u017cne czynniki, najcz\u0119\u015bciej infekcje, zw\u0142aszcza\u00a0paciorkowcowe.<br \/><strong>OPIS PRZYPADKU.<\/strong>\u00a0Pacjent, lat 74, zosta\u0142 przyj\u0119ty do Kliniki z powodu zmian sk\u00f3rnych, kt\u00f3re pojawi\u0142y si\u0119\u00a0w okolicy uk\u0105szenia przez \u017cmij\u0119 zygzakowat\u0105, do kt\u00f3rego dosz\u0142o p\u00f3\u0142 roku wcze\u015bniej. Przy przyj\u0119ciu obserwowano\u00a0dobrze odgraniczony rumie\u0144 i obrz\u0119k prawego podudzia z towarzysz\u0105c\u0105 gor\u0105czk\u0105. Postawiono rozpoznanie\u00a0r\u00f3\u017cy i w\u0142\u0105czono do\u017cylnie ceftriakson. Dwa dni p\u00f3\u017aniej w tej samej okolicy pojawi\u0142o si\u0119 kilka tkliwych\u00a0guzk\u00f3w. W oparciu o obraz kliniczny oraz histopatologiczny zdiagnozowano odmian\u0119 B\u00e4vferstedta (erythema\u00a0nodosum migrans). Kontynuowano leczenie, z p\u00f3\u017aniejsz\u0105 zamian\u0105 antybiotyku na doustn\u0105 doksycyklin\u0119, co\u00a0skutkowa\u0142o popraw\u0105 kliniczn\u0105.<br \/><strong>WNIOSKI.<\/strong> Niniejsze doniesienie opisuje niezwykle rzadkie wsp\u00f3\u0142wyst\u0119powanie r\u00f3\u017cy i rumienia guzowatego\u00a0w odmianie B\u00e4vferstedta, tym bardziej, \u017ce obserwowane choroby pojawi\u0142y si\u0119 w miejscu pierwotnego uk\u0105szenia\u00a0przez \u017cmij\u0119 zygzakowat\u0105. Najprawdopodobniej jad \u017cmii spowodowa\u0142 zaburzenia kr\u0105\u017cenia krwi i limfy, co\u00a0predysponowa\u0142o do r\u00f3\u017cy, a ta, jako infekcja paciorkowcowa, sprowokowa\u0142a rumie\u0144 guzowaty.<\/p><\/jats:p>","DOI":"10.32394\/pe.74.28","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T14:16:44Z","timestamp":1603721804000},"page":"355-361","source":"Crossref","is-referenced-by-count":0,"title":["Rare coexistence of unilateral erythema nodosum with erysipelas in the area of previous adder bite"],"prefix":"10.32394","volume":"74","author":[{"given":"J","family":"Nowowiejska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Baran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Flisiak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"17323","published-online":{"date-parts":[[2020,10,19]]},"container-title":["Przeglad Epidemiologiczny"],"original-title":["Rzadki przypadek wsp\u00f3\u0142wyst\u0119powania jednostronnego rumienia guzowatego i r\u00f3\u017cy w miejscu pierwotnego uk\u0105szenia przez \u017cmij\u0119 zygzakowat\u0105"],"link":[{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180942-101505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180942-101505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T08:45:48Z","timestamp":1709887548000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/Rare-coexistence-of-unilateral-erythema-nodosum-with-erysipelas-in-the-area-of-previous,180942,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,19]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020]]}},"alternative-id":["180942"],"URL":"https:\/\/doi.org\/10.32394\/pe.74.28","relation":{},"ISSN":["0033-2100","2545-1898"],"issn-type":[{"value":"0033-2100","type":"print"},{"value":"2545-1898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,19]]}}}