Predictors of recurrent cellulitis in five years. Clinical risk factors and the role of PTX3 and CRP - 11/04/15

Doi : 10.1016/j.jinf.2014.11.002

Matti Karppelin ^a,^⁎ , Tuula Siljander ^b, Janne Aittoniemi ^c, Mikko Hurme ^c,^d, Reetta Huttunen ^a, Heini Huhtala ^e, Juha Kere ^f,^g,^h, Jaana Vuopio ^b,ⁱ, Jaana Syrjänen ^a,^j
^a Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
^b Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, P.O. Box 57, FI-20521 Turku, Finland
^c Department of Clinical Microbiology, Fimlab Laboratories, P.O. Box 66, FI-33101 Tampere, Finland
^d Department of Microbiology and Immunology, School of Medicine, University of Tampere, FI-33014 University of Tampere, Finland
^e School of Health Sciences, University of Tampere, FI-33014 University of Tampere, Finland
^f Department of Medical Genetics, University of Helsinki, P.O. Box 33, FI-00014 University of Helsinki, Finland
^g Department of Biosciences and Nutrition, and Clinical Research Centre, Karolinska Institutet, SE-141 83 Huddinge, Sweden
^h Science for Life Laboratory, P.O. Box 1031, SE-17121 Solna, Sweden
ⁱ Department of Medical Microbiology and Immunology, Medical Faculty, University of Turku, FI-20014 Turun Yliopisto, Finland
^j Medical School, University of Tampere, FI-33014 Tampereen Yliopisto, Finland

^∗Corresponding author. Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland. Tel.: +358 3 3116 6639; fax: +358 3 3116 4368.

Summary

Objectives

To identify risk factors for recurrence of cellulitis, and to assess the predictive value of pentraxin 3 (PTX3) and C-reactive protein (CRP) measured at baseline.

Methods

A follow up study of 90 hospitalised patients with acute non-necrotising cellulitis was conducted. Clinical risk factors were assessed and PTX3 and CRP values were measured at baseline. Patients were contacted by phone at a median of 4.6 years after the baseline episode and the medical records were reviewed.

Results

Overall, 41% of the patients had a recurrence in the follow up. Of the patients with a history of a previous cellulitis in the baseline study 57% had a recurrence in five year follow up as compared to 26% of those without previous episodes (p = 0.003). In multivariate analysis, only the history of previous cellulitis was identified as an independent predicting factor for recurrence. The levels of pentraxin 3 (PTX3) or C-reactive protein (CRP) in the acute phase did not predict recurrence.

Conclusions

Risk of recurrence is considerably higher after a recurrent episode than after the first episode. Clinical risk factors predisposing to the first cellulitis episode plausibly predispose also to recurrences.

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Highlights

•	Recurrence rate of acute bacterial cellulitis in five years was 41%.
•	Risk of recurrence in five years was 26% for patients with no previous episodes.
•	Risk of recurrence was 56% after a recurrent cellulitis episode.
•	Previous cellulitis predicts recurrence.

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Keywords : Cellulitis, Erysipelas, Recurrence, PTX3, CRP

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Vol 70 - N° 5

P. 467-473 - mai 2015 Retour au numéro

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Predictors of recurrent cellulitis in five years. Clinical risk factors and the role of PTX3 and CRP - 11/04/15

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