Lower limb cellulitis: low diagnostic accuracy and underdiagnosis of risk factors

Mistry, Khaylen; Sutherland, Melanie; Levell, N. J.

doi:10.1111/ced.13930

Cited by 8 publications

(6 citation statements)

References 7 publications

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“…Mistry et al 9 insisted that cellulitis was confirmed only in 31.9% of patients referred for suspicion of lower limb cellulitis in an English university center. Other diagnoses included venous eczema, chronic edema and lymphedema.…”

Section: Discussionmentioning

confidence: 99%

Cellulitis risk factors for patients with primary or secondary lymphedema

Vignes¹,

Poizeau

Dupuy

2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Section: Discussionmentioning

confidence: 99%

Cellulitis risk factors for patients with primary or secondary lymphedema

Vignes¹,

Poizeau

Dupuy

2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…No validated diagnostic criteria or tools exist,4 and up to 68% of people with suspected lower‐limb cellulitis (LLC) may not have the condition,5 leading to unnecessary hospital admission and antibiotic treatment 6. Painful red legs may also be caused by chronic conditions such as venous eczema and lymphoedema, which are unresponsive to antibiotics 5. This study investigated whether (i) a shorter duration of symptoms and (ii) a shorter duration of antibiotic treatment predicted whether referred patients had LLC.…”

Section: Figurementioning

confidence: 99%

“…6 Painful red legs may also be caused by chronic conditions such as venous eczema and lymphoedema, which are unresponsive to antibiotics. 5 This study investigated whether (i) a shorter duration of symptoms and (ii) a shorter duration of antibiotic treatment predicted whether referred patients had LLC. Diagnosis was defined clinically by experienced dermatologists.…”

mentioning

confidence: 99%

Longer duration of lower‐limb symptoms makes cellulitis diagnosis less likely in secondary care

Mistry

Levell

2020

Br J Dermatol

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Prior studies on other inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus have shown that the disease influences rates of preterm birth and pregnancy loss. 2 No statistically significant differences were detected when comparing our study cohort with the general population of women in the US in terms of the rates of miscarriage, 3 C-section, 4 premature baby, 4 stillbirth 5 and perinatal mortality. 5 In addition, baseline HS disease severity was not significantly associated with poorer pregnancy or neonatal outcomes. Thus, our findings on pregnancy outcomes can help providers counsel and reassure concerned pregnant patients with HS regarding pregnancy outcomes. In contrast, compared with rates of gestational diabetes mellitus, 6 gestational hypertension 7 and pre-eclampsia 8 in the US general population, our study cohort had a higher than average rate for each condition, with statistical significance detected for gestational hypertension (P = 0Á022) and pre-eclampsia (P = 0Á017). Therefore, screening for these conditions among pregnant patients with HS is essential. Study limitations include: that it took place at a single academic centre, was retrospective and contained missing data. Lack of systematic follow-up of neonatal charts could have resulted in underestimation of the perinatal mortality rate. Only univariate analysis was conducted; thus, potential confounders have not been controlled for. In summary, our study suggests that HS does not portend an increased risk of poor pregnancy or neonatal outcomes. Large, prospective pregnancy registries are needed to collect data on maternal and neonatal outcomes in patients with HS.

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“…Patients should always be checked for tinea pedis, which should be treated with topical or systemic antifungals . Secondary cellulitis should be treated early with oral or intravenous penicillin V or flucloxacillin, or with clarithromycin if penicillin‐sensitive.…”

Section: Management Of Trench Foot: Vasodilators To Avoid Amputation?mentioning

confidence: 99%

A review of trench foot: a disease of the past in the present

2019

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Summary From the French Invasion of Russia in 1812, to Glastonbury festival in 2007, trench foot has been reported, yet the exact nature of the condition remains unclear. This review explores the pathogenesis and treatment of trench foot. Trench foot is considered to be a nonfreezing cold injury often complicated by infection, in which exposure to cold temperatures just above freezing, combined with moisture, results in a peripheral vasoneuropathy. The presence of physical trauma, bacterial or fungal infections, malnutrition, venous hypertension and lymphoedema mean that some individuals are at greater risk of trench foot. Trench foot may be prevented by warming the feet, changing socks, staying active, rubbing the skin with oil and regularly inspecting the feet. Avoiding risk factors may help prevent the condition. The management of trench foot is less clear. Vasodilators such as iloprost and nicotinyl tartrate or sympathectomy may help. Trench foot may lead to necrosis, cellulitis, sepsis and amputation. It remains a poorly understood condition.

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Lower limb cellulitis: low diagnostic accuracy and underdiagnosis of risk factors

Cited by 8 publications

References 7 publications

Cellulitis risk factors for patients with primary or secondary lymphedema

Cellulitis risk factors for patients with primary or secondary lymphedema

Longer duration of lower‐limb symptoms makes cellulitis diagnosis less likely in secondary care

A review of trench foot: a disease of the past in the present

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