Erysipelas

Complaints of pain in an ear prompted the mother of a 4-year-old boy to seek medical consultation for her son. The external ear was red, swollen, and warm. This appearance is typical of erysipelas caused by group A β-hemolytic streptococci.

The superficial cellulitis may appear on the face or the extensor surfaces of the legs or arms. Sites of previous lymphedema are susceptible to erysipelas.

This youngster was treated with penicillin, and the condition resolved rapidly. Erythromycin can be used for patients who cannot take penicillin; cloxacillin or cephalexin may be tried for antibiotic-resistant infections.