Risk Factors for Cellulitis Arising on the Lower Extremities: A Prospective Study of Hospitalized Patients

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  • 下肢蜂窩織炎のリスクファクター：教室入院例のprospectiveな検討
  • カシ ホウカシキエン ノ リスク ファクター キョウシツ ニュウインレイ ノ prospective ナ ケントウ

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A prospective study of hospitalized patients with cellulitis on the lower extremities was carried out in our department to elucidate the risk factors. Twenty-six patients, including 16 males and 10 females, were enrolled in the study for a period of ten months between April 2008 and January 2009. The average age was 52 years. Our study indicates that obesity (50.0% in men, 80.0% in women) and tinea pedis (80.8%) are important predisposing factors. Detailed questioning disclosed that the patients had previous histories of orthopedic injuries (57.7%) such as fractures and sprains; cellulitis (38.5%) was much more frequent in the involved lower extremity than in the uninvolved one. On average, the cellulitis occurred approximately 30 years after the orthopedic injury. This long period seems to be the reason why the link between these two conditions has been overlooked. We repeatedly examined ASO and ASK titers for the period of hospitalization and follow-up in our outpatient clinic. Unexpectedly, significant alterations in these titers suggesting streptococcal infection were found in 53.8% of the patients. When the patients were divided into two groups depending on the positivity of streptococcal infection, the positive group was found to be associated with female patients, purpura on cellulitis lesions, regional lymphadenopathy, and a previous history of cellulitis in the involved extremity.

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