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Cellulitis complicating lymphoedema.

P C Woo1, P N Lum, S S Wong

  • 1Department of Microbiology, The University of Hong Kong, Queen Mary Hospital.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|June 2, 2000
PubMed
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Cellulitis complicating lymphoedema in cancer patients presents with longer illness duration and higher rates of positive blood cultures. Early self-initiated treatment may mitigate bacterial spread and lymphatic damage.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Lymphology

Background:

  • Cellulitis is a common bacterial skin infection.
  • Lymphoedema, often a consequence of cancer treatment, can predispose individuals to infections.
  • The interplay between lymphoedema and cellulitis, particularly in cancer patients, requires further investigation.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of cellulitis in patients with lymphoedema.
  • To compare the incidence of positive blood cultures and duration of symptoms in patients with and without lymphoedema.
  • To explore potential management strategies for cellulitis complicating lymphoedema.

Main Methods:

  • Retrospective case series of ten hospitalised patients with cellulitis complicating lymphoedema over a 3-year period.

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  • Comparison with 20 age- and sex-matched controls hospitalised for cellulitis without lymphoedema.
  • Analysis of underlying conditions, blood culture results, and duration of fever, tachycardia, and cellulitis.

    • Main Results:

    • The underlying causes of lymphoedema included various carcinomas (cervix, uterus, vagina, breast, nasopharynx) and retroperitoneal squamous cell carcinoma.
    • Three of ten patients with lymphoedema had positive blood cultures, versus none in the control group.
    • Patients with lymphoedema experienced significantly longer durations of fever (P<0.05), tachycardia (P<0.05), and cellulitis (P<0.005).

    Conclusions:

    • Cellulitis in the context of lymphoedema, especially in cancer survivors, is associated with a higher risk of bacteraemia and prolonged inflammatory response.
    • Prompt recognition and early patient-initiated treatment may be crucial for controlling bacterial proliferation and preventing further lymphatic system damage.
    • Further research into optimal treatment protocols for this vulnerable patient group is warranted.