Lower limb cellulitis in non-diabetic patients: a prospective study
DOI:
https://doi.org/10.18203/2349-2902.isj20182250Keywords:
Cellulitis, CREST guidelines, Lower limb, Non-diabeticAbstract
Background: Lower limbs are commonly involved in cellulitis as they are more susceptible to injuries. This study analyzes the various causes and risk factors for cellulitis in the non-diabetics.
Methods: This prospective study was conducted at the Department of General Surgery, Government Thanjavur Medical College and included 100 non-diabetic patients with lower limb cellulitis. The severity of cellulitis was graded as per the CREST guidelines. Demographics, risk factors, grades, management and treatment outcomes were recorded and analyzed.
Results: Cellulitis was more common in females (58%) and old age group (37%). It was more unilateral (86%) and resulted more from post bite wounds (21%). 76% had culture-positive wound infections. Severe grades of cellulitis needed surgical intervention and many patients needed skin grafting.
Conclusions: Nondiabetic patients with lower limb cellulitis can also result in severe morbid consequences but in the absence of co-morbid illness, they usually recover with minimal residual disabilities. Nondiabetic elderly patients have to be motivated to take care of their feet as the diabetic patients, as neglect of minor trauma or bites can lead to morbid illness necessitating major treatment like skin grafting.
References
Baddour LM, Bisno AL. Non-group A beta-hemolytic streptococcal cellulitis: association with venous and lymphatic compromise. Am J Med. 1985;79:155-9.
Bengalorkar GM, Kumar TN. Diabetic foot infections: A review. Int J Biol Med Res. 2011;2(1):453-60.
Carratala` J, Roso´n B, Ferna´ndez-Sabe´ N, Shaw E, del Rio O, Rivera A, et al. Factors associated with complications and mortality in adult patients hospitalized for infectious cellulitis. Eur J Clin Microbiol Infect Dis. 2003;22:151-7.
Chartier C, Grosshans E. Erysipelas. Int J Dermatol. 1990;29:459-67. 12. Lazzarini L, Conti E, Tositti G, de Lalla F. Erysipelas and cellulitis: clinical and microbiological spectrum in an Italian tertiary care hospital. J Infect. 2005;51:383-9.
Dupuy A, Benchikhi H, Roujeau JC, Bernard P, Vaillant L, Chosidow O, et al. Risk factors for erysipelas of the leg (cellulitis): a case-control study. BMJ. 1999;318:1591-4.
Eriksson B, Jorup-Ro¨nstro¨m C, Karkkonen K, Sjo¨blom AC, Holm SE. Erysipelas: clinical and bacteriologic spectrum and serological aspects. Clin Infect Dis. 1996;23:1091-8.
Girish MB, Kumar TN, Srinivas R. Pattern of antimicrobials used to treat infected diabetic foot in a tertiary care hospital in Kolar. Int J Pharm Biomed Res. 2010;1(2):48-52.
Lipsky BA, Berendt AR, Deery HG. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004;39(7):885-910.
Guidelines on the management of cellulitis in adults. Clinical Resource Efficiency Support Team (CREST) June 2005;2(3):560-5.
Rongey CA, Runyon B. Cellulitis in patients with cirrhosis and edema: an under-recognized complication more common than spontaneous bacterial peritonitis. Am J Gastroenterol. 2003;290-4.
Björnsdóttir S, Gottfredson M, Thórisdóttir AS. Risk factors for acute cellulitis of the lower limb: a prospective case-control study. Clin Infect Diseas. 2005:1416-22.
Smith SR, Reed JF. Prevalence of mixed infections in the diabetic pedal wound: a perspective based on a national audit. Int J Lower Extremity Wounds. 2002;1(2):125-8.
Semel JD, Goldin H. Association of athlete’s foot with cellulitis of the lower extremities: diagnostic value of bacterial cultures of ipsilateral interdigital space samples. Clin Infect Dis. 1996;23:1162-4.
Shankar EM, Mohan V, Premalatha G, Srinivasan RS, Usha AR. Bacterial etiology of diabetic foot infections in South India. Eur J Intern Med. 2005;16:567-70.
Gadepalli RB, Dhawan V, Sreenivas A, Kapil AC, Ammini C, Chaudhry RR. A clinical-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital. Diabetes Care. 2006;29:1727-32.
Roujeau JC, Sigurgeirsson B, Korting HC, Kerl H, Paul C. Chronic dermatomycoses of the foot as risk factors for acute bacterial cellulitis of the leg: a case-control study. Dermatol. 2004;209:301-7.