This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 13. Infectious Diseases Chapter 157.
Nondermal infection is rare, usually occuring as arthritis or endocarditis.
Within a week of injury, a characteristic raised, purplish red, nonvesiculated, indurated, maculopapular rash appears, accompanied by itching and burning. Local swelling, though sharply demarcated, may inhibit use of the hand, the usual site of infection. The lesion's border may slowly extend outward, causing discomfort and disability that may persist for 3 wk. Bacteremia is rare but may result in septic arthritis or infective endocarditis even in those without known valvular heart disease. Isolation from synovial fluid or blood is necessary for the diagnosis of erysipelothrical arthritis or endocarditis.