Cutaneous cellulitis

Sachs, M. K.

doi:10.1001/archderm.127.4.493

Cited by 12 publications

(10 citation statements)

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“…We excluded patients <15 years of age and patients with an abscess or necrotizing fasciitis (defined by frank cutaneous necrosis on physical examination or fascial edema and necrosis detected during surgery). Erysipelas was defined as sudden onset (<24 h) of a well-demarcated acute dermohypodermatitis considered to be nonnecrotizing cellulitis with fever >38°C or chills [10, 11]. Among the 124 cases included, 10 were excluded because they failed to fulfill the inclusion criteria (4 had cellulitis elsewhere, 2 had recurrent erysipelas, 1 had no mention of the affected side, 1 was <15 years old, 2 had been matched to excluded controls).…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Erysipelas of the Leg in Tunisia: A Multicenter Case-Control Study

et al. 2006

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Background: Risk factors for erysipelas (cellulitis) were rarely evaluated in controlled studies. Regional variations of these risk factors have never be assessed. Objective: To assess risk factors for erysipelas of the leg in Tunisia. Subjects and Methods: Case-control study in seven hospital centers in Tunisia. Cases were 114 consecutive patients with erysipelas of the leg [sudden onset (<24 h) of a well-demarcated dermo-hypodermatitis with fever or chills]. Two controls were matched to each case for age, sex, and hospital (n = 208). Main outcome measures are local and general suspected risk factors for erysipelas of the leg. Results: In multivariate analysis, disruption of the cutaneous barrier (i.e. traumatic wound, toe-web intertrigo, excoriated leg dermatosis or plantar squamous lesions) and leg edema were independently associated with erysipelas of the leg, with respective odds ratios of 13.6 (95% confidence interval: 6.0–31) and 7.0 (1.3–38). No association was observed with diabetes, alcoholism, or smoking. Conclusions: We confirmed the major role of local risk factors and the minor role of general risk factors for erysipelas of the leg, in a setting different than the one previously studied. Detecting and treating toe-web intertrigo and traumatic wounds should be considered in the prevention of erysipelas of the leg.

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Section: Methodsmentioning

confidence: 99%

Risk Factors for Erysipelas of the Leg in Tunisia: A Multicenter Case-Control Study

et al. 2006

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“…This distinction must have contributed to our more accurate results. Many authors support the theory that NSAIDs decrease inflammatory clinical symptoms causing a delay in treatment which is the cornerstone of NF prognosis (Sachs 1991;Browne et al 1996;Jonville-Bera et al 2001). The effect of diclofenac on NF in rabbits supports that point of view (Guibal et al, 1998) as well as a human case-control study with ibuprofen (Zerr et al 1999).…”

Section: Discussionmentioning

confidence: 96%

Does diclofenac increase the risk of cervical necrotizing fasciitis in a rat model?

Eter

Khazzaka

Mneimneh

et al. 2009

Int J Experimental Path

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Non-steroidal anti-inflammatory drugs (NSAIDs) are known for aggravating in vitro infections and were reported in many cases of cervical necrotizing fasciitis (CNF). We developed a rat model of CNF, mimicking as closely as possible the human-CNF, to study the effect of a NSAIDs, diclofenac, as a promoting factor. Twenty rats were injected bilaterally in the neck with peptostreptococcus and with a fresh saliva specimen for another 20 rats. Half of each group was given an intramuscular injection of 4 mg/kg diclofenac at the time of inoculation and 24 h later, and the other half saline injections; rats were killed at day 7 and clinical, bacterial and histological studies were performed to assess the infectious process and the incidence of CNF. No statistically significant difference was found between groups treated with diclofenac vs. the saline injection groups. However a significant correlation was noted between clinical observation, bacterial density and histological signs of inflammation. CNF has a high mortality rate and the use of NSAIDs in conditions potentially leading to CNF is very common. However, our rat model does not support the hypothesis of a promoting role of diclofenac which was occasionally suggested in the medical literature. This study suggests that diclofenac does not seem to increase the risk of occurrence of CNF. Nonetheless, NSAIDs can mask inflammatory signs of an already spreading CNF.

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“…Aspiration and culture of tissue fluid by a variety of techniques and blood cultures give limited results 2-4,6,8,14-1 6,22,24-26 , which is difficult to explain 11,27 . During an attack of cellulitis, bacteria should abound and therefore be easy to culture.…”

Section: Discussionmentioning

confidence: 99%

“…In an animal model, however, positive cultures could only be obtained early in an attack, suggesting an initial period where there is bacterial proliferation. The host's natural defence mechanisms then rapidly clear tissue bacterial concentration to a level too low to culture 27 . This, however, fails to explain the prolonged clinical syndrome of pain, swelling and tissue changes.…”

Section: Discussionmentioning

confidence: 99%

Eighty-five consecutive cases of cellulitis: clinical features, management and implications for hospital care

Butcher¹,

Papworth²,

Parvin³

et al. 2003

Phlebology

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Objectives: To determine lessons learned from a consecutive series of patients admitted with cellulitis, regarding factors leading to admission, management and duration of hospitalization. Methods: Prospective data over a 12-month period within a district general hospital. Centralized admitting policy of all patients with a principle diagnosis of cellulitis under the vascular surgical department. Data comparison of younger patients vs older and of those hospitalized for less than one week vs more than one week. Results: Of 85 patients admitted, 44 had previous oedema and 50 had a skin lesion as a portal for entry of infection; only nine had neither prior to the attack. Thirty-two had had at least one previous attack of cellulitis. Younger patients tended to have a more virulent systemic infection whereas older patients had more comorbidity and social problems. Fourteen patients required surgical intervention: eight had arterial and six had venous contributory circulatory disorders. Microbiological information was of minimal practical value. Surgical intervention and social problems were associated with delayed discharge. Conclusions: The majority of patients with cellulitis had predisposing oedema/skin lesions and where these persisted or recurrent infection occurred long-term antibiotic prophylaxis may have been useful. Social problems and comorbidity remained complicating factors but more patients could probably have been managed in a domiciliary setting.

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Cutaneous cellulitis

Cited by 12 publications

References 0 publications

Risk Factors for Erysipelas of the Leg in Tunisia: A Multicenter Case-Control Study

Risk Factors for Erysipelas of the Leg in Tunisia: A Multicenter Case-Control Study

Does diclofenac increase the risk of cervical necrotizing fasciitis in a rat model?

Eighty-five consecutive cases of cellulitis: clinical features, management and implications for hospital care

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