DOI: https://dx.doi.org/10.18203/2349-2902.isj20222359
Published: 2022-09-28

Study of prognostic outcome of cellulitis patients with diabetes mellitus

Navjot Kaur

Abstract


Background: Cellulitis is a non-suppurative, invasive infection of tissues, which is usually related to point of injury. It is a spreading inflammation. It is an acute bacterial infection causing inflammation of the deep dermis and surrounding subcutaneous tissue. To reduce morbidity and mortality early diagnosis and management with identification of co morbidities and treating them down is necessary. To make a full assessment of the cause, all patients require a detailed history, examination and investigations.

Methods: This is a cross sectional comparative study of 50 patients having symptoms of cellulitis to be divided into two groups of 25 patients each where one group is having diabetes mellitus and other group without diabetes mellitus.

Results: Diabetes mellitus patients have more morbidity and mortality in term of more days of hospital stay, rate of amputations and number of debridement. Early diagnosis, broad spectrum antibiotics and early aggressive debridement is the mainstay of management. Aggressive surgical debridement at initial stages of presentation can halt the clinical process and patient can have better prognosis. In neglected diabetic patients’ debridement alone is not sufficient and amputation may be required in some cases.

Conclusions: Early diagnosis, broad spectrum antibiotics and early aggressive debridement in cellulitis patients results in better outcomes.


Keywords


Cellulitis, Broad spectrum antibiotics, Diabetes mellitus, Debridements

Full Text:

PDF

References


Begon E. Erysipèles,dermohypodermites bactériennes et fasciites nécrosantes. EMC Dermatol. 2013;8(2):1-10.

Amal S, Houass S, Laissaoui K, Moufid K, Trabelsi M. Érysipèle: profil épidémiologique, clinique et évolutif dans la région de Marrakech (100 observations). Médecine Mal Infect. 2004;34(4):171-6.

Chlebicki MP, Oh CC. Recurrent Cellulitis: Risk Factors, Etiology, Pathogenesis and Treatment. Curr Infect Dis Rep. 2014;9(29):16.

Kourouma Sarah KY. Comparative Study of Necrotizing Bacterial Dermohypodermitis or Necrotizing Fasciitis Depending on the HIV Serostatus in Abidjan. J Clin Exp Dermatol Res. 2014;9(5):5.

Leclerc S, Teixeira A, Mahé E, Descamps V, Crickx B, Chosidow O. Recurrent Erysipelas: 47 Cases. Dermatology. 2006;12(1):52-7.

Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med. 199;334:240-5.

Baddour LM. Cellulitis syndromes: an update. Int J Antimicrob Agents. 2000;14:113-6.

Baddour LM, Bisno AL. Recurrent cellulitis after saphenous venectomy for coronary bypass surgery. Ann Intern Med. 1982;97:493-6.

Kremer M, Zuckerman R, Avraham Z, Raz R. Long-term antimicrobial therapy in the prevention of recurrent soft-tissue infections. J Infect. 1991;22:37-40.

Cranendonk DR, Lavrijsen APM, Prins JM, Wiersinga WJ. Cellulitis: current insights into pathophysiology and clinical management. Neth J Med. 2017;75(9):366-78.

Clayton W, Elasy TA. A review of the pathophysiology, classification and treatment of foot ulcers in diabetic patients. Clin Diabetes. 2009;27(2):52-8.

Ahmed AA, Elsharief E, Alsharief A. The diabetic foot in the Arab world. J Diab Foot Comp. 2011;3(3):55-61.

Jain AKC. A new classification of diabetic foot complications: A simple and effective teaching tool. J Diab Foot Comp. 2012;4(1):1-5.

Jain AKC. A new staging system for cellulitis in diabetic lower limbs-improving diabetic foot practice around the world. J Diab Foot Comp. 2014;6(2):48-53.

Singh G, Bharpoda P, Reddy R. Necrotizing fasciitis: a study of 48 cases. Indian J Surg. 2015;12(2):345-50.

Mzabi A, Marrakchi W, Alaya Z, Fredj FB, Rezgui A, Bouajina E, Kechrid CL. Cellulitis in aged persons: a neglected infection in the literature. Pan Afr Med J. 2017;27:160.

Carratalà J, Rosón B, Fernández-Sabé N, Shaw E, del Rio O, Rivera A, Gudiol F. Factors associated with complications and mortality in adult patients hospitalized for infectious cellulitis. Eur J Clin Microbiol Infect Dis. 2003;22(3):151-7.

Burian EA, Karlsmark T, Franks PJ, Keeley V, Quéré I, Moffatt CJ. Cellulitis in chronic oedema of the lower leg: an international cross-sectional study. Br J Dermatol. 2021;185(1):110-8.