Cellulitis--epidemiological and clinical characteristics.

2012

Hadzovic-Cengic M, Sejtarija-Memisevic A, Koluder-Cimic N, Lukovac E, Mehanic S, Hadzic A, Hasimbegovic-lbrahimovic S.

Source

Clinic for Infectious Diseases, Clinical Center of University of Sarajevo, Bosnia and Herzegovina. melica74@gmail.com

Abstract

INTRODUCTION: 

Cellulitis is acute skin infection and/or infection of subcutaneous tissue, mostly caused by Streptococcus pyogenes and Staphylococcus aureus. Clinical preview is usually obvious and enough for diagnosis. Tretment is antimicrobial therapy. In recurrent cases a prophylaxis is very often needed.

OBJECTIVES:

Analysis some of the epidemiological and clinical characteristics of cellulitis.

PATIENTS AND METHODS:

Retrospective analysis of medical documentation of patients with clinical preview of cellulitiswho were hospitalized in Clinic for infective diseases of Clinical Center of University of Sarajevo in last three years.

RESULTS:

In period of three years 123 patients were hospitalized with clinical preview of cellulitis in the broadest sense of the word. In 123 of cellulitises, 35/123 (28.45%) were erisipelases-superficial type and 88/123 (71,55%) were deep cellulitises. Men were more affected 56,09%, average of age was 50.22 years. Before hospitalization patients had ambulance treatment in average of 5.12 days, and hospitalization was long in average of 13.33 days. Risk factors wich contributes to the disease were found in 71.54% of cases. Due to localisation, skin disorders on lower limb were the most frequent 71.56%,cellulitis of upper limb were found in 12.19%, head and/or neck in 13.08%, trunk in 3.25%. Repetition of disease were found in 4.8% in patients wtih risk factors. Bacteremic isolats were confirmed in 27.64% of cases. In all patients empirical antibiotic treatment were started, in the 62.60% the first choice of medicine was antibiotic from the group of lincosamides.

CONCLUSION:

Cellulitis is very serious disease that can be prevented.

PubMed

Molecular typing of beta-hemolytic streptococci from two patients with lower limb cellulitis: identical isolates in toe web and blood specimens.

Molecular typing of beta-hemolytic streptococci from two patients with lower limb cellulitis: identical isolates in toe web and blood specimens.

J Clin Microbiol. 2007 Jul 3;

Ingibjörg Hilmarsdóttir* and Freyja Valsdóttir
Department of Microbiology, Landspítali University Hospital, Reykjavík, Iceland
* To whom correspondence should be addressed. Email: ingibjh@landspitali.is

Hilmarsdóttir I, Valsdóttir F.
Department of Microbiology, Landspítali University Hospital, Reykjavík, Iceland.

Intertriginous toe webs harbouring cellulitis-causing bacteria constitute a risk factor for lower limb cellulitis. Molecular typing of Streptococcus pyogenes and S. dysgalactiae subspecies equisimilis isolates from blood and toe webs of two cellulitis patients revealed identical strains for each species. This finding supports the role of toe webs as a potential site of entry for cellulitis pathogens.

Journal of Clinical Microbiology

Risk factors for acute cellulitis of the lower limb: a prospective case-control study.

Clin Infect Dis. 2005 Nov

Björnsdóttir S, Gottfredsson M, Thórisdóttir AS, Gunnarsson GB, Ríkardsdóttir H, Kristjánsson M, Hilmarsdóttir I.
Department of Medicine, Division of Infectious Diseases, Landspítali University Hospital, Reykjavik, Iceland.

BACKGROUND: Acute bacterial cellulitis is a potentially serious infection that commonly recurs. The identification of preventable risk factors could reduce infection-related morbidity and cost and improve patient management. The aim of this study was to identify the risk factors associated with lower-limb cellulitis, including both analysis of risk factors associated with cellulitis in either limb and risk factors in a single limb associated with cellulitis in the same limb. We placed particular emphasis on dermatophytic infections of the foot and bacterial infection and colonization of the toe webs.

METHODS: We conducted a prospective case-control study of 100 subjects with cellulitis and 200 control subjects, matched for age and sex, who were admitted to a university hospital during the period October 2000-February 2004. Data were obtained with a questionnaire and from examination of lower limbs and microbiological analyses of samples from the feet.

RESULTS: The median age of the participants was 66.5 years (interquartile range, 48.8-77.0). The following risk factors were strongly and independently associated with cellulitis: previous history of cellulitis (OR, 31.04; 95% CI, 4.15-232.20), the presence of Staphylococcus aureus and/or beta -hemolytic streptococci in the toe webs (OR, 28.97; 95% CI, 5.47-153.48), presence of leg erosions or ulcers (OR, 11.80; 95% CI, 2.47-56.33), and prior saphenectomy (OR, 8.49; 95% CI, 1.62-44.52). Tinea pedis interdigitalis was associated with cellulitis only when toe web bacteria were excluded from the analysis (OR, 3.86; 95% CI, 1.32-11.27).

CONCLUSIONS: Risk factors for acute bacterial cellulitis in hospitalized patients include predisposing factors and the presence of sites of pathogen entry on legs and toe webs. These findings indicate that improved awareness and management of toe web intertrigo, which may harbor bacterial pathogens, and other skin lesions might reduce the incidence of cellulitis.

University of Chicago Journals * Full Text Article