Acute non-necrotizing
cellulitis is a skin
infection with a tendency to recur. Both general and local risk factors for
erysipelas or
cellulitis have been recognized in previous studies using hospitalized controls. The aim of this study was to identify risk factors for
cellulitis using controls recruited from the general population. We also compared patients with a history of previous
cellulitis with those suffering a single episode, with regard to the risk factors:
length of stay in hospital, duration of
fever, and inflammatory response as measured by
C-reactive protein (CRP) level and leukocyte count. Ninety hospitalized
cellulitis patients and 90 population controls matched for age and sex were interviewed and clinically examined during the period April 2004 to March 2005. In multivariate analysis, chronic oedema of the extremity, disruption of the cutaneous barrier and
obesity were independently associated with acute
cellulitis. Forty-four (49%) patients had a positive history (PH) of at least one
cellulitis episode before entering the study.
Obesity and previous ipsilateral
surgical procedure were statistically significantly more common in PH patients, whereas a recent (<1 month) traumatic
wound was more common in patients with a negative history (NH) of
cellulitis. PH patients had longer duration of
fever and
hospital stay, and their CRP and leukocyte values more often peaked at a high level than those of NH patients. Oedema, broken skin and
obesity are risk factors for acute
cellulitis. The inflammatory response as indicated by CRP level and leukocyte count is statistically significantly more severe in PH than NH patients.