Purpose of the study. To find out the mortality rate in patients with necrotic form of erysipelas and the reasons that cause it. Materials and metods. 284 case histories of patients who were hospitalized in the center of purulent-septic surgery of KNP «City Hospital № 3» in Zaporozhye for the period 2016–2021 were analyzed. Results. It is established that in the general population of the disease, 14,1% of patients suffer from the necrotic form of erysipelas. In the complex treatment of patients with surgical forms of erysipelas, the main place belongs to antibiotic therapy (ABT) and early surgical treatment of the area of the pathological process. Determination of procalcitonin in blood serum makes it possible to assess the progression of the inflammatory process and is a sensitive test for the effectiveness of treatment. Conclusion. In 72,5% of cases, the disease was aggravated by sepsis with a mortality of 67,5%. The cause of mortality in patients with necrotic erythema is numerous irreversible changes in the internal organs.

Objective. The aim is to find out the common and different features of the clinical course of erysipelas from other diseases that can imitate it. Materials and methods. 114 case histories of patients who were hospitalized in the center of purulent-septic surgery in the City Hospital No 3 in Zaporizhzhia for the period 2019-2020 were analyzed. 123 patients, who underwent hospital treatment in the center during this period of time, were with post-injection abscesses of soft tissue, 184 - with soft tissue abscesses, 203 - with phlegmons of various localizations, 49 - with complicated panaritium, 3 of which - subcutaneous. Over the past 5 years, 127 patients were consulted in the clinic and other therapeutic, infectious, neurological and other departments of the city. A number of criteria and signs have been identified to differentiate erysipelas from diseases that may have similar clinical symptoms and a number of circumstances that need to be clarified. Results. It is established that the diagnosis of erysipelas does not require special laboratory examination and is made on the basis of examination of the patient, epidemiological history and medical history. Provoking factors in the development of erysipelas are: violation of the integrity of the skin (abrasions, scratches, abrasions, cracks, bruises, injuries); mycoses; a sharp change in temperature (supercooling, overheating); emotional stress; increased insolation. Erysipelas has a characteristic summer-autumn seasonality. In people engaged in physical labor, the disease is registered more often than in other types of work. Hereditary predisposition to the disease is observed in 10-15% of cases. In this regard, the presence of such factors as congenital and acquired venous insufficiency of the lower extremities, fungal infection of the lower extremities, the presence of postoperative and post-traumatic scars, lymphostasis, diabetes, cardiovascular disease and diseases accompanied by the development of edema, intake of corticosteroids or cytostatics are of essential significance in the development of the disease. Conclusions. Mathematical modeling between erysipelas and other diseases that have similar syndromes in their clinical picture may be useful in making a differential diagnosis between them.

The ideal marker of bacterial infection should not only allow for early diagnosis, but also provide information about the course and prognosis of the disease. Nowadays the most well-studied and widely used in clinical practice is procalcitonin (PCT), but its value in surgical forms of erysipelas is insufficiently defined. The aim of the article is to determine the diagnostic and prognostic significance of procalcitonin in patients with surgical forms of erysipelas.114 case histories of patients who were hospitalized in the center of purulent-septic surgery of the Non-profit municipal enterprise "City Hospital №3" in Zaporozhye for 2019-2020 period were analyzed retrospectively and prospectively. It was found that most often the focus was localized on the lower extremities. In the complex treatment of patients with erysipelas, the main place belongs to antibiotic therapy (ABT) and early surgical treatment of the area of the pathological process. Determination of the level of procalcitonin in the serum makes it possible to assess the progression and generalization of the process and is a sensitive test for the effectiveness of treatment.Radical surgery and timely targeted ABT are key elements of success in the treatment of surgical forms of erysipelas and are not subject to revision. Procalcitonin is a diagnostic marker that can predict the development of sepsis.

Objective. To investigate the efficacy of immunomodulating and immunostimulating therapy in complex treatment of patients, suffering surgical forms of erysipelas.Materials and methods. Retrospectively and prospectively there were analyzed 284 patients’ hospital charts, who were treated stationary in Centre of Purulent-Septic Surgery of Zaporizhzhya Municipal Hospital №3 in 2016 - 2021 yrs. Results. In patients, suffering erythematous form of erysipelas, disorders in cellular and humoral chains of immunity were not revealed. The immune disorders formula in bullous form was following: CD3 + 1, CD4 + 1, CD8-1, CD16-2, CD22-1, what witnessed about misbalance of the immune system Degree I, of possibly compensatory character; in a phlegmonous one - CD3 + 1, CD4-1, CD8-1, CD16-2, CD22-1, witnessing actuality of the immune disorders of Degree І, while in the necrotic one - CD3-2, CD4-2, CD8-1, CD16-2, CD22-1, trusting presence of the immune disorders of Degree ІІI. Conclusion. Administration of erbisol-extra and laferon for destructive forms of erysipelas is pathogenetically substantiated and may be applied in complex treatment of the disease.

Objective. To improve the results of treatment in patients, suffering diabetic foot syndrome (DFS), using conduction of the directed antibacterial therapy, taking into account the resistance of microflora revealed, and to reveal the role of a gram-positive microflora in occurrence of complications. Materials and methods. There were examined 1824 patients, suffering DFS for period from 2015 to 2019 yr., who suffered purulent-necrotic affections of the foot - abscess, phlegmon, purulent tendovaginitis, purulent arthritis, gangrene. All the patients suffered diabetes mellitus Type 2, average duration of which have constituted (12.3 ± 2.7) yrs. Qualitative content of microflora and sensitivity of cultures for antibiotics were revealed  on automatic microbiological analizators «Vitek2» and BacT/ALERT (France). Results. The cause of purulent-necrotic complications was a gram-positive microflora, which in 57.1 - 66.8% patients was diagnosed in monoinfection and prevailed in a content of microbial associations. Phenomena of resistance to the main antibacterial preparations was revealed in 37.4% bacteria. The biggest resistance have had Staphylococcus aureus and Enterococcus faecalis. In 62.5% patients, owing Staphylococcus aureus, a resistance gene to Staphylococcus aureus with three genetic variations were revealed, which differed in accordance to resistance for certain groups of antibiotics. The most significant MRSA Type 3 - panresistant (in 6/2% patients). Conclusion. Investigations of purulent-necrotic foci in patients with the DFS witnesses, that the leading microorganism while development of complications constitutes a gram-positive  microflora, which is characterized by presence of polyresistant and panresistant strains. Such a condition gives background to necessity for correcting of the antibacterial therapy administered.