A STUDY OF RISK FACTORS AND COMPLICATIONS OF LIMB CELLULITIS IN RURAL MEDICAL COLLEGE, MAHABUBNAGAR, TELANGANA STATE

Dr. Jeevan Kenche, Dr. E. Chandrashekar Reddy

Abstract


Cellulitis is a common infection of the skin and subcutaneous tissues. It is associated with significant morbidity. The identification of risk factors and complications can help to reduce the morbidity, mortality, financial burden and to  improve the management.

Aim: To study the risk factors and complications of lower limb cellulitis inpatients at rural medical college, Mahabubnagar, Telangana State.

Methods:  We conducted a prospective study on 50 patients with cellulitis in either limb, who were admitted in surgical wards, medical wards, surgical and medical intensive care units of Government general hospital/ Government Medical college, Mahabubnagar, Telangana state, between period of April  2018 to September 2018. Detailed history and clinical examination of all patients were noted. Relevant investigations were done and were appropriately managed. They were managed conservatively or surgically depending on severity and followed up till complete recovery or 30 days after discharge whichever was earlier.

Results: The present study had 50 patients with male to female ratio of 2.8:1. Males were affected more than females. Most common age group affected was 51-60 years (16 patients, 32%) range between 24 to 80 years. Out of 50 patients 36 patients (72%) had lower limb involvement and 14 patients (28%) had upper limb involvement In lower limb, leg was affected in 38 patients (76%) whereas foot was involved in 12 patients (14%).All patients had swelling, redness and pain as presenting features whereas fever was present 35 patients (70%). Most cultures from the local site (28 patients, 56%) had negative growth. Most common organism grown was E. coli.  Most common risk factor was bare foot walking as seen in  35 patients (70%) patients followed by alcohol intake and smoking (30 patients each, 60%), diabetes (15, 30%), hypertension (13, 26%), direct trauma (10,20%). Local complications including compartment syndrome (6 patients, 12%) and necrotizing fasciitis (4 patients, 8%) were seen in 10 patients (20%). Systemic complication of multiple organ dysfunction syndromes was seen in 4 patients (8%) patients.

Conclusion: Creating awareness among the rural population regarding the entity of cellulitis, risk factors associated with it especially walking bare foot, alcohol, smoking and diabetes mellitus and the need for early recognition and treatment to prevent serious complications is an important aspect to be followed.


Keywords


cellulitis, risk factors of cellulitis, complications of cellulitis

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References


. Dennis L. Stevens, Infection of the skin, Muscles and Soft tissues, Harrison’s principles of internal medicine, page No. 827-833, Vol. 2, 19th Edition

Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med 1996;334:240–5.

Bonnetblanc JM, Bédane C. Erysipelas: recognition and management. Am J ClinDermatol2003;4:157–63.

Phoenix G, Das S, Joshi M. Diagnosis and management of cellulitis. BMJ 2012;345:e4955. BMJ Open: first published as 10.1136/bmjopen-2017-021175 on 23 July 2018. Downloaded from http://bmjopen.bmj.com/ on 25 October 2018 by guest. Protected by copyright.

Crickx B, Chevron F, Sigal-Nahum M, et al. [Erysipelas: epidemiological, clinical and therapeutic data (111 cases)]. Ann DermatolVenereol1991;118:11–16.

Bernard P, Chosidow O, Vaillant L; French Erysipelas Study Group. Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial. BMJ 2002;325:864.

Cox NH, Management of lower leg cellulitis. Clin Med. 2002:2(1):23-7

Trubo R, Bisno AL, Hacker SM, Roaten SP. Today’s strategies for bacterial skin infections.Patient Care. 1997:31:78-94.

Bernard P, Chosidow O, Vaillant L; French Erysipelas Study Group.Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial. BMJ 2002;325:864.

Chartier C, Grosshans E. Erysipelas. Int J Dermatol1990;29:459–67.

Jorup-Rönström C. Epidemiological, bacteriological and complicating features of erysipelas. Scand J Infect Dis 1986;18:519–24.

Krasagakis K, Samonis G, Valachis A, et al. Local complications of erysipelas: a study of associated risk factors. ClinExpDermatol 2011;36:351–4.

Africa CiS;Pages. http:// global-disease burden.healthgrove. com/ l/ 82932/ Cellulitis- in- South- Africa

Kassebaum NJ, Arora M, Barber RM, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 2016;388:1603–58.

Transforming our world: the 2030 Agenda for Sustainable Development. Sustainable Development Knowledge Platform. https:// sustainable development. un. org/ post2015/

Björnsdóttir S, Gottfredsson M, Thórisdóttir AS, et al. Risk factors for acute cellulitis of the lower limb: a prospective case-control study. Clin Infect Dis 2005;41:1416–22.

Dupuy A, Benchikhi H, Roujeau JC, et al. Risk factors for erysipelas of the leg (cellulitis): case-control study. BMJ 1999;318:1591–4.

Swati G. Deshpande, Ankur Grover et al., Limb cellulitis in rural setting in India: a case control study, International Surgery Journal Int Surg J. 2017 Aug;4(8):2751-2755

Didde Sundara Chakravarthy, Kiran Kumar Gandeti et al., Prospective study on sociodynamics of cellulitis in general surgical unit, International Journal of Research in Medical Sciences Int J Res Med Sci. 2015 May;3(5):1052-1055

Tsi Njim, Leopold Ndemnge Aminde et al., Risk factors of lower limb cellulitis in a level two healthcare facility in Cameroon: a case-control study, BMC Infect Dis. 2017;17:418

Chandalia HB, Das AK. Detection of the diabetic foot at risk on diabetes 1988. Larkins RG, Zimmet PZ, Chisholm DJ, eds. Excerpta Medica. Amsterdam: ICS 800; 1989:1057-1062.

Morris A. Cellulitis and erysipelas. Clin Evid. 2003:9:1804-9.

Goettsch WG, Bouwes Bavinck JN, Herings RM. Burden of illness of bacterial cellulitis and erysipelas of the leg in the Netherlands. J Eur Acad Dermatol Venereol. 200:20(7):834-9.


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