In case of classic erysipelas, there is no requirement of laboratory workup for treatment or
diagnosis. However, elevations and leukocytosis in ESR (erythrocyte sedimentation rate) and
CRP (C-reactive protein) are common. Routine tissues as well as blood cultures aren’t cost-
effective as they are having extremely poor yield and
results have very low impact on
Usually imaging studies aren’t indicated and they are of low yield. MRI (magnetic resonance
imaging) as well as bone scintigraphy will be helpful when earlier osteoarticular involvement
will be suspected. In such settings, typically standard radiographic findings will be normal.
Erysipelas Histologic hallmarks are vascular dilatation, streptococcal invasion of tissues and
lymphatics, and marked dermal edema. The bacterial invasion results in dermal inflammatory
infiltrate that includes neutropils as well as mononuclear cells. Epidermis often is secondarily
involved. Bacterial invasion rarely of local blood vessels can be seen.
These are positive in just five percent of the cases whereas culture and Gram stain of rash
usually not helpful. Bacterial cultures however might be useful when question of concern or
diagnosis about bacteremia exists with metastatic infection. Cultures can be of little benefits
in patients who have different intravascular devices or artificial joints or are with prosthetic
heart valves or toxic-appearing or immuno-compromised patients. From portal of entry,
bacterial cultures can be highly helpful in individuals having atypical clinical presentations.