Online ISSN 2313-1519
Print    ISSN 1812-2892
Abstract - Risk factors, disease management and complications in patients with cellulitis
Hülya Nazik, Mehmet Kamil Mülayim, Perihan Öztürk, Selçuk Nazik, Mehmet Enes Güner, Mine Müjde Kuş


Introduction: Cellulitis is an acute bacterial infection of deep dermal lymphatics, whereas erysipelas is an acute bacterial infection of superficial dermal lymphatics. In this study, it was aimed to investigate demographic, clinical and laboratory characteristics of adult cellulitis/erysipelas patients followed up in our clinic and to reveal the relationship with disease.

Material and methods: Forty-two adult patients who were hospitalized with the diagnosis of cellulitis/erysipelas at Dermatology Clinic were evaluated. Demographic characteristics, habits, presence of facilitating factors, comorbidities, duration of hospitalization, received treatments and complications were investigated and recorded.

Results: The mean age of the patients was 58.9±13.1 and the male/female ratio was 1.1. 92.9% of the cases had cellulitis and 7.1% of them were erysipel. The lesions were located in lower extremities in 88.1% of cases. All patients admitted to hospital for the complaints of swelling and redness while 81% of patients who admitted to hospital had pain. The most frequently detected comorbidity was diabetes. All of patients with recurrent episodes had chronic lymphedema. When local complications were evaluated, in three cases abscess was seen and in 2 cases skin necrosis was seen.

Conclusion: In this study, smoking-Maraş Powder use, diabetes, obesity, history of surgical operation, superficial fungal infection were detected in high rates among cellulitis patients. Ampicillin sulbactam treatment was found to be effective in patients with cellulitis/erysipelas. It was found that length of hospital stay is increased for the patients who received antibiotherapy late. Formation of abscess was associated with delayed initiation of antibiotherapy.

Key words: cellulitis, erysipelas, risk factors, management, complications

Corresponding author: Hülya Nazik, MD, Associate Professor, Department of Dermatology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, 46100, Turkey. Tel.: +90 505 501 91 62. E-mail:



1. Hadzovic-Cengic M, Sejtarija-Memisevic A, Koluder-Cimic N, Lukovac E, Mehanic S, Hadzic A, et al. Cellulitis-epidemiological and clinical characteristics. Med Arch. 2012; 66(1):51-S53.

2. Pitché PV, Saka B, Diatta AB, Faye O, Diané BF, Sangaré A, et al. Risk factors associated with abscess formation among patient with leg erysipelas (cellulitis) in sub-Saharan Africa: a multicenter study. BMC Dermatol. 2015; 15:18.

3. Krasagakis K, Samonis G, Valachis A, Maniatakis P, Evangelou G, Tosca A. Local complications of erysipelas: a study of associated risk factors. Clin Exp Dermatol. 2011; 36(4):351-S354.

4. Dong SL, Kelly KD, Oland RC, Holroyd BR, Rowe BH. ED management of cellulitis: a review of five urban centers. Am J Emerg Med. 2001; 19(7):535-540.

5. Turhan Ö, Saba R, Öngüt G, Yalçın AN, Mamıkoğlu L. Bir üniversite hastanesinde izlenen 68 selülit olgusunun değerlendirilmesi. Klimik Dergisi. 2006; 19:114-116.

6. Karppelin M, Siljander T, Vuopio-Varkila J, Kere J, Huhtala H, Vuento R, et al. Factors predisposing to acute and recurrent bacterial non-necrotizing cellulitis in hospitalized patients: a prospective case-control study. Clin Microbiol Infect. 2010; 16(6):729-734.

7. Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005; 41(10):1373-1406.

8. Pavlotsky F, Amrani S, Trau H. Recurrent erysipelas: risk factors. J Dtsch Dermatol Ges. 2004; 2(2):89-95.

9. Lewis SD, Peter GS, Gomez-Marin O, Bisno AL. Risk factors for recurrent lower extremity cellulitis in a U.S. Veterans Medical Center population. Am J Med Sci. 2006; 332(6):304-307.

10. Mehdi L, Ekinci AP, Baykal C. Retrospective Evaluation of Risk Factors and Response in Treatment among Hospitalized Patients with Lower-Extremity Cellulitis. Turk J Dermatol. 2016; 10:59-64.

11. Sardas S, Cimen B, Karsli S, Yurdun T, Donbak L. Comparison of genotoxic effect between smokeless tobacco (Maras powder) users and cigarette smokers by the alkaline comet assay. Hum Exp Toxicol. 2009; 28(4):214-219.

12. Chlebicki MP, Oh CC. Recurrent cellulitis: risk factors, etiology, pathogenesis and treatment. Curr Infect Dis Rep. 2014; 16(9):422.

13. Carratalà J, Rosón B, Fernández-Sabé N, Shaw E, del Rio O, Rivera A, et al. Factors associated with complications and mortality in adult patients hospitalized for infectious cellulitis. Eur J Clin Microbiol Infect Dis. 2003; 22(3):151-157.

14. Sadow KB, Chamberlain JM. Blood cultures in the evaluation of children with cellulitis. Pediatrics. 1998; 101(3):1-4.

15. Perl B, Gottehrer NP, Raveh D, Schlesinger Y, Rudensky B, Yinnon AM. Cost-effectiveness of blood cultures for adult patients with cellulitis. Clin Infect Dis. 1999; 29(6):1483-1488.

16. Bailey E, Kroshinsky D. Cellulitis; diagnosis and management. Dermatol Ther. 2011; 24(2):229-239.

17. Concheiro J, Loureiro M, Gonzalez-Vilas D, García-Gavín J, Sánchez-Aguilar D, Toribio J. Erysipelas and cellulitis: a retrospective study of 122 cases. Actas Dermosifiliogr. 2009; 100(10):888-894.

18. Morpeth SC, Chambers ST, Gallagher K, Frampton C, Pithie AD. Lower limb cellulitis: features associated with length of hospital stay. J Infect. 2006; 52(1):23-29.

19. Figtree M, Konecny P, Jennings Z, Goh C, Krilis SA, Miyakis S. Risk stratification and outcome of cellulitis admitted to hospital. J Infect. 2010; 60(6):431-439.


Volume 4, Number 58 (2020)