Erysipelas in Tunisian Patients: Epidemiological, Clinical Features and Risk Factors in Internal Medicine
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 5, Issue 3
Abstract
Background: The purpose of our work was to study the epidemiological, clinical features and risk factors of erysipelas in Internal Medicine. Methods: Retrospective study including 86 patients with erysipelas collected at our department of internal medicine between 2005 and 2016. Results: There were 44 men and 42 women. The average age of our patients was 57.77. Erysipelas mainly affected the lower limbs in 95.3% of cases. Fever was present in 47.67% of cases. General underlying conditions were dominated by diabetes (55.8%), obesity (37.2%) and overweight (31.4%). Loco-regional favoring factors were essentially represented by lymphedema (18.6%), venous insufficiency (12.8%) and arteritis of the lower limbs (12.8%). A local site of entry was identified in 83.7% of the cases. The average number of total favorable factors was 3.12. Laboratory findings revealed leukocytosis in 66.3% of cases and CRP elevation in 77.6% of the cases. Bacteriological investigations identified gram negative bacilli in 3 patients: on blood cultures (Klebsiella Pneumoniae) and samples from needle aspirate (Enterobacter Cloacae and Serratia Marcescens). Erysipelas was recurrent in 45.34% of cases. Risk factors for recurrence were mycosis and lymphedema. Conclusion: Prevention of erysipelas is essentially based on the treatment of local and general factors. Clinicians must be aware to the possibility of other causative microorganisms like GNB in front of erysipelas. Erysipelas is known to be an acute non-necrotizing bacterial dermohypodermitis mainly due to group A beta hemolytic streptococci. In Internal Medicine, the main difficulty is to identify patients at risk of getting worse because many of our patients are immunocompromised. Another challenge in our practice is to identify the causative organisms in case of non-response to classic treatment. The purpose of our work was to study the epidemiological, clinical and risk factors of erysipelas. We conduct a retrospective study including 86 patients with erysipelas collected at Tunisian department of internal medicine between 2005 and 2016. We included in our study the files of hospitalized patients for erysipelas admitted by the emergencies or the external consultation. The diagnosis of erysipelas was made in the presence of an erysipelatoid edematous placard, well limited, surrounded or not by a peripheral bead associated or not with general signs. We excluded from our study all erythematous rashes that did not relate to erysipelas and complications such as cellulitis and necrotizing fasciitis.
Authors and Affiliations
Kechaou k, Ben Haj Yahya M, Cherif E, Boukhris I, Ben Hassine
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