Prevalence and Epidemiological Factors Involved in Cellulitis in Korean Patients With Lymphedema
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objective To evaluate the prevalence and associated factors involved in cellulitis with lymphangitis among a group of Korean patients who were being treated for lymphedema. We present our epidemiologic research and we also report a systematic review of these types of cases.Methods This was a retrospective medical record study among 1,246 patients diagnosed with lymphedema. The study was carried out between January 2006 and December 2012 at the Kosin University Gospel Hospital and Seoul National University Bundang Hospital. Cases were examined for onset time, affected site, seasonal trend, and recurrence pattern of lymphedema, lymphangitis, and cellulitis. We also evaluated the history of blood-cell culture and antibiotic use.Results Ninety-nine lymphedema patients experienced complications such as cellulitis with accompanying lymphangitis. Forty-nine patients had more than two recurrences of cellulitis with lymphangitis. The incidence and recurrence of cellulitis with lymphangitis were significantly higher in the patients with lower-extremity lymphedema. There was a significant trend toward higher cellulitis prevalence in the lower-extremity lymphedema group according to the time of lymphedema onset. Among the cellulitis with lymphangitis cases, 62 cases were diagnosed through blood-cell culture; 8 of these 62 cultures were positive for β-hemolytic streptococci. Conclusion The prevalence rate of cellulitis with lymphangitis in patients with lymphedema was 7.95%, and the prevalence of recurrent episodes was 3.93%. Especially, there was high risk of cellulitis with lymphangitis after occurrence of lower-extremity lymphedema with passage of time. Lymphedema patients should be fully briefed about the associated risks of cellulitis before treatment, and physicians should be prepared to provide appropriate preventive education.
Abstract
Objective To evaluate the prevalence and associated factors involved in cellulitis with lymphangitis among a group of Korean patients who were being treated for lymphedema. We present our epidemiologic research and we also report a systematic review of these types of cases.Methods This was a retrospective medical record study among 1,246 patients diagnosed with lymphedema. The study was carried out between January 2006 and December 2012 at the Kosin University Gospel Hospital and Seoul National University Bundang Hospital. Cases were examined for onset time, affected site, seasonal trend, and recurrence pattern of lymphedema, lymphangitis, and cellulitis. We also evaluated the history of blood-cell culture and antibiotic use.Results Ninety-nine lymphedema patients experienced complications such as cellulitis with accompanying lymphangitis. Forty-nine patients had more than two recurrences of cellulitis with lymphangitis. The incidence and recurrence of cellulitis with lymphangitis were significantly higher in the patients with lower-extremity lymphedema. There was a significant trend toward higher cellulitis prevalence in the lower-extremity lymphedema group according to the time of lymphedema onset. Among the cellulitis with lymphangitis cases, 62 cases were diagnosed through blood-cell culture; 8 of these 62 cultures were positive for β-hemolytic streptococci. Conclusion The prevalence rate of cellulitis with lymphangitis in patients with lymphedema was 7.95%, and the prevalence of recurrent episodes was 3.93%. Especially, there was high risk of cellulitis with lymphangitis after occurrence of lower-extremity lymphedema with passage of time. Lymphedema patients should be fully briefed about the associated risks of cellulitis before treatment, and physicians should be prepared to provide appropriate preventive education.
참고문헌 (27)
- Smeltzer DM, "Primary lymphedema in children and adolescents: a follow-up study and review", Pediatrics, 76, pp.206~218 (1985)
- WHO Expert Committee on Filariasis, "Lymphatic filariasis:fourth report of the WHO Expert Committee on Filariasis", World Health Organ Tech Rep Ser, 702, pp.3~112 (1984)
- Rockson SG, "Estimating the population burden of lymphedema", Ann N Y Acad Sci, 1131, pp.147~154 (2008)
- Godoy JM, "Sensitivity and specificity of combined perimetric and volumetric evaluations in the diagnosis of arm lymphedema", Prague Med Rep, 108, pp.243~247 (2007)
- Swartz MN, "Clinical practice. Cellulitis", N Engl J Med, 350, pp.904~912 (2004)
- Cox NH, "Management of lower leg cellulitis", Clin Med (Lond), 2, pp.23~27 (2002)
- Damstra RJ, "Erysipelas as a sign of subclinical primary lymphoedema: a prospective quantitative scintigraphic study of 40 patients with unilateral erysipelas of the leg", Br J Dermatol, 158, pp.1210~1215 (2008)
- Masmoudi A, "Erysipelas after breast cancer treatment (26 cases)", Dermatol Online J, 11, pp.12~ (2005)
- El Saghir NS, "Erysipelas of the upper extremity following locoregional therapy for breast cancer", Breast, 14, pp.347~351 (2005)
- de Godoy JM, "Prevalence of cellulitis and erysipelas in post-mastectomy patients after breast cancer", Arch Med Sci, 3, pp.249~251 (2007)
- de Godoy JM, "Lymphoscintigraphic evaluation in patients after erysipelas", Lymphology, 33, pp.177~180 (2000)
- Tsao H, "Bacterial cellulitis", Curr Opin Dermatol, 4, pp.33~41 (1997)
- Dupuy A, "Risk factors for erysipelas of the leg (cellulitis): case-control study", BMJ, 318, pp.1591~1594 (1999)
- Shih YC, "Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: a 2-year follow-up study", J Clin Oncol, 27, pp.2007~2014 (2009)
- Teerachaisakul M, "Diet, C-reactive protein levels and cellulitis in patients with lymphedema: a cross-sectional study", J Med Med Sci, 2, pp.1297~1301 (2011)
- Lewis SD, "Risk factors for recurrent lower extremity cellulitis in a U.S. Veterans Medical Center population", Am J Med Sci, 332, pp.304~307 (2006)
- Scheinfeld NS, "Obesity and dermatology", Clin Dermatol, 22, pp.303~309 (2004)
- Bjornsdottir S, "Risk factors for acute cellulitis of the lower limb: a prospective case-control study", Clin Infect Dis, 41, pp.1416~1422 (2005)
- Duvanel T, "Quantitative cultures of biopsy specimens from cutaneous cellulitis", Arch Intern Med, 149, pp.293~296 (1989)
- Moffatt CJ, "Lymphoedema: an underestimated health problem", QJM, 96, pp.731~738 (2003)
- Soo JK, "Lymphatic abnormalities demonstrated by lymphoscintigraphy after lower limb cellulitis", Br J Dermatol, 158, pp.1350~1353 (2008)
- Collins PS, "Abnormalities of lymphatic drainage in lower extremities: a lymphoscintigraphic study", J Vasc Surg, 9, pp.145~152 (1989)
- Woo PC, "Cellulitis complicating lymphoedema", Eur J Clin Microbiol Infect Dis, 19, pp.294~297 (2000)
- Badger C, "Antibiotics", anti-inflammatories for reducing acute inflammatory episodes in lymphoedema of the limbs, 2004, pp.(2), CD003143~
- Baddour LM, "Non-group A beta-hemolytic streptococcal cellulitis: association with venous and lymphatic compromise", Am J Med, 79, pp.155~159 (1985)
- Mortimer PS, "Chronic peripheral oedema: the critical role of the lymphatic system", Clin Med (Lond), 4, pp.448~453 (2004)
- Perl B, "Cost-effectiveness of blood cultures for adult patients with cellulitis", Clin Infect Dis, 29, pp.1483~1488 (1999)