Recurrent erysipelas - risk factors and clinical presentation

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• 作者：Malin Inghammar ; Magnus Rasmussen ; Adam Linder
• 关键词：Erysipelas ; Skin infection ; Recurrent ; Risk factor
• 刊名：BMC Infectious Diseases
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：182 KB
• 参考文献：1. Goettsch, WG, Bouwes Bavinck, JN, Herings, RM (2006) Burden of illness of bacterial cellulitis and erysipelas of the leg in the Netherlands. JEADV 20: pp. 834-839
  2. Bartholomeeusen, S, Vandenbroucke, J, Truyers, C, Buntinx, F (2007) Epidemiology and comorbidity of erysipelas in primary care. Dermatology 215: pp. 118-122 CrossRef
  3. Bisno, AL, Stevens, DL (1996) Streptococcal infections of skin and soft tissues. N Engl J Med 334: pp. 240-245 CrossRef
  4. Bonnetblanc, JM, Bedane, C (2003) Erysipelas: recognition and management. Am J Clin Dermatol 4: pp. 157-163 CrossRef
  5. Eriksson, B, Jorup-R?nstrom, C, Karkkonen, K, Sjoblom, AC, Holm, SE (1996) Erysipelas: clinical and bacteriologic spectrum and serological aspects. Clin Infect Dis 23: pp. 1091-1098 CrossRef
  6. Bernard, P, Bedane, C, Mounier, M, Denis, F, Catanzano, G, Bonnetblanc, JM (1989) Streptococcal cause of erysipelas and cellulitis in adults: a microbiologic study using a direct immunofluorescence technique. Arch Dermatol 125: pp. 779-782 CrossRef
  7. Siljander, T, Karppelin, M, Vahakuopus, S, Syrjanen, J, Toropainen, M, Kere, J, Vuento, R, Jussila, T, Vuopio-Varkila, J (2008) Acute bacterial, nonnecrotizing cellulitis in Finland: microbiological findings. Clin Infec Dis 46: pp. 855-861 CrossRef
  8. Chartier, C, Grosshans, E (1990) Erysipelas. Int J Dermatol 29: pp. 459-467 CrossRef
  9. Musette, P, Benichou, J, Noblesse, I, Hellot, MF, Carvalho, P, Young, P, Levesque, H, Courtois, H, Caron, F, Lauret, P, Joly, P (2004) Determinants of severity for superficial cellutitis (erysipelas) of the leg: a retrospective study. Eur J Intern Med 15: pp. 446-450 CrossRef
  10. Jorup-R?nstrom, C (1986) Epidemiological, bacteriological and complicating features of erysipelas. Scand J Infect Dis 18: pp. 519-524 CrossRef
  11. Jorup-R?nstrom, C, Britton, S (1987) Recurrent erysipelas: predisposing factors and costs of prophylaxis. Infection 15: pp. 105-106 CrossRef
  12. Dupuy, A, Benchikhi, H, Roujeau, JC, Bernard, P, Vaillant, L, Chosidow, O, Sassolas, B, Guillaume, JC, Grob, JJ, Bastuji-Garin, S (1999) Risk factors for erysipelas of the leg (cellulitis): case–control study. BMJ 318: pp. 1591-1594 CrossRef
  13. Roujeau, JC, Sigurgeirsson, B, Korting, HC, Kerl, H, Paul, C (2004) Chronic dermatomycoses of the foot as risk factors for acute bacterial cellulitis of the leg: a case–control study. Dermatology 209: pp. 301-307 CrossRef
  14. Simon, MS, Cody, RL (1992) Cellulitis after axillary lymph node dissection for carcinoma of the breast. Am J Med 93: pp. 543-548 CrossRef
  15. Karppelin, M, Siljander, T, Vuopio-Varkila, J, Kere, J, Huhtala, H, Vuento, R, Jussila, T, Syrjanen, J (2010) Factors predisposing to acute and recurrent bacterial non-necrotizing cellulitis in hospitalized patients: a prospective case–control study. Clin Microbiol Infect 16: pp. 729-734 CrossRef
  16. Sterne, JA, White, IR, Carlin, JB, Spratt, M, Royston, P, Kenward, MG, Wood, AM, Carpenter, JR (2009) Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 338: pp. b2393 CrossRef
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• 刊物主题：Infectious Diseases; Parasitology; Medical Microbiology; Tropical Medicine; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2334

文摘

Background Erysipelas is a common infection that often recurs, but the impact of specific risk factors for reoccurrence remains elusive. In the present study we aimed at clarifying predisposing conditions for reoccurrence. Methods Medical records were reviewed from all patients ?8?years of age diagnosed with erysipelas at the Department of Infectious Diseases at Sk?ne University Hospital, Sweden, from January 2007 to February 2011. 502 patients were included, of which 357 were single episode erysipelas and 145 had recurrent erysipelas. These two groups were compared regarding underlying conditions and clinical presentation. Results Erysipelas in the lower limbs had the greatest propensity of recurrence. The associations between underlying conditions and recurrence were largely depending on the site of erysipelas. Overall, the most prominent risk factor for recurrence was lymphedema and other conditions causing a chronic impairment of the defence against microbes. Conditions temporarily disrupting the skin barrier (e.g. a local wound or toe web intertrigo), although likely being risk factors for erysipelas per se, did not seem to predispose to repeated episodes. Individuals with recurrent erysipelas tended to seek medical attention earlier, and were less likely to be hospitalized or receive intravenous antibiotics, but there was no evidence of any difference in inflammatory reaction when taking confounding factors into account. Conclusions In this large cross-sectional study of over 500 patients with erysipelas, lymphedema was the most prominent risk factors for recurrence although the distribution of predisposing conditions varies depending on the site of erysipelas.