Endocarditis may develop in a few cases. Epidemiology Erysipelothrix rhusiopathiae is found in mammals, poultry, and fish. The typical, nonpyogenic lesions on occupationally exposed persons suggest erysipeloid. Since there is no wound, a swab is not useful. Bacteria can be cultured from a biopsy of the progressing, inflamed edge of the lesion.
Blood culture is indicated in the setting of sepsis and endocarditis.
Control Penicillin is the drug of choice to treat serious infections. Since local skin infection is self-limited, therapy is not essential. The pathogenic role of Propionibacterium acnes is still disputed. Nevertheless, in compromised patients even this nonpathogenic species may induce pathologic reactions, such as endocarditis. In skin lesions P acnes is often found with other pathogenic bacteria, such as Staphylococcus aureus or actinomycetes, and is thought to support the damaging effect of those pathogens.