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Evolutionary Profile of Cellulitis and Erysipelas of Lower Limbs in a Level-Two Healthcare Facility in Brazzaville, Congo

Received: 24 January 2020    Accepted: 12 February 2020    Published: 19 February 2020
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Abstract

Background: Cellulitis/erysipelas are the most frequent reason for hospitalization in dermatology departments. Objective: To describe evolutionary profile of cellulitis/erysipelas and to determine associated factors with the long hospital stay. Methods: This was a cross-sectional study carried out from January 2016 to December 2018 in Talangaï Reference Hospital, that included patients hospitalized for cellulitis or erysipelas of the lower limbs. Necrotizing fasciitis cases were excluded. A hospital stay of more than 11 days was considered long. Sociodemographic, clinical and biological data were collected and processed with Epi Info 7.2.1.0. The Chi-square and Fisher tests were used for univariate analysis. Logistic regression was used for multivariate analysis. Results: One hundred and five patients were included, with an average age of 50.7 (±15) years. They were 26 (24.8%) men and 79 (74.2%) women. Antibiotic regimen used was amoxicillin in 19 (18.1%) cases, amoxicillin / clavulanic acid in 40 (38.1%) cases and ceftriaxone in 46 (43.8%) cases. The outcome was favorable in 69 (65.7%) patients. Fever persisted after 5 days-treatment in 19 (28.3%) patients out of 67 initially. Complications were cutaneous necrosis in 19 (18.0%) cases, abscess in 14 (13.3%) cases, severe sepsis and necrotizing fasciitis in 7 and 4 cases, respectively. Two patients died. The average length of hospital stay was 13 days (±7.5) and 44 (41.9%) cases had a long hospital stay. The bullous forms of cellulitis/erysipelas [aOR=4.8, 95%CI (1.9-12.4); p=0.001] and the occurrence of complications [aOR=3.2, 95%CI (1.1-8.7); p=0.026] were associated with a long hospital stay. Conclusion: Cellulitis and erysipelas are potentially serious. Despite treatment, complications can occur, including necrosis and abscess. Effective management, including early medical treatment, daily thorough monitoring of patients, appropriate local care and collaboration with surgeons, is necessary to improve the prognosis of the disease.

Published in International Journal of Infectious Diseases and Therapy (Volume 5, Issue 1)
DOI 10.11648/j.ijidt.20200501.12
Page(s) 4-8
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Cellulitis, Erysipelas, Complication, Abscess, Hospitalization, Congo

References
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[4] Blackberg, A., Trell, K. and Rasmussen, M (2015). Erysipelas, a large retrospective study of aetiology and clinical presentation. BMC Infect Dis 15: 402.
[5] Gunderson, C. G. and Martinello, R. A (2012). A systematic review of bacteremias in cellulitis and erysipelas. J Infect 64: 148-155.
[6] Christensen, K. L., Holman, R. C., Steiner, C. A., Sejvar, J. J., Stoll, B. J. and Schonberger, L. B (2009). Infectious disease hospitalizations in the United States. Clin Infect Dis 49: 1025-1035.
[7] Lamchahab, F. E., Beqqal, K., Guerrouj, B., Khoudri, I., Senouci, K., Hassam, B et al (2010). Bilan d’hospitalisation du service de dermatologie-vénérologie du CHU Ibn Sina Rabat Maroc. Pan Afr Med J 7: 17.
[8] Keita, M., Koulibaly, M., Soumah, M. M., Diané, B., Tounkara, T. M., Camara, A. D. et al (2014). Morbidité et mortalité hospitalières dans le service de dermatologie-MST du CHU de Conakry (Guinée). Ann Dermatol Venereol 141 (12) Suppl: S356-S357.
[9] Sartelli, M., Guirao, X., Hardcastle, T. C., Kluger, Y., Boermeester, M. A., Raşa, K et al (2018). 2018 WSES/SIS-E consensus conference: recommendations for the management of skin and soft-tissue infections. World J Emerg Surg 13: 58.
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[13] Saka, B., Kombaté, K., Mouhari-Touré, A., Akakpo, S. Boukari, T., Pitché, P et al (2011). Dermo-hypodermites bactériennes et fasciitis nécrosantes: 104 observations au Togo. Med Trop 71: 162- 164.
[14] Amal, S., Houass, S., Laissaoui, K., Moufid, K., Trabelsi, M (2004). Epidemiology, clinical features, and evolution of Erysipelas in the Marrakech region (100 cases). Med Mal Infect 34: 171-176.
[15] Mascitti H, Dinh A., Tourte M., Duran C., Hanslik T., Perronne C. et al (2019). Identification des facteurs de risque de non-réponse précoce des érysipèles hospitalisés. Ann Dermatol Venereol 146 (12) Suppl: a118-a119.
[16] Roda Â., Pinto A. M., Filipe A. R., Travassos A. R., Freitas J. P and Filipe P (2019). Clinical and laboratory factors associated with prolonged hospital stay among patients with cellulitis/erysipelas. Acta Medica Portuguesa, 32 (6): 448-452.
[17] Njim, T., Ndemnge Aminde, L., Ndip Agbor, V., Toukam, L. D., Kashaf, S. S., Ohuma, E. D (2007). Risk factors of lower limb cellulitis in a level-two healthcare facility in Cameroon: a case-control study. BMC Infect Dis 17: 418.
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[19] Lenga Loumingou, I. A., Loumongou, J. R., Soussa, R. and Gathsé, A (2013). Complications des érysipèles au C. H. U de Brazzaville. Ann Univ M Ngouabi 14 (5): 55-60.
[20] Pitché, P. V., Saka, B., Diatta, A. B., Faye, O., Diané, B. F., Sangaré, A. et al (2015). Risk factors associated with abscesse formation among patient with leg erysipelas (cellulitis) in sub-saharan Africa: a multicenter study. BMC Dermatology 15: 18.
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[23] Picard, D., Klein, A., Grigioni, S., Joly and P (2013). Risk factors for abscess formation in patients with superficial cellulitis (erysipelas) of leg. Br J Dermatol 168: 859-863.
[24] Morpeth, S. C., Chambers, S. T., Gallagher, K., Frampton, C. and Pithie, A. D (2006). Lower limb cellulitis: features associated with length of hospital stay. J Infect 52 (1), 23-29.
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    Edith Sophie Bayonne-Kombo, Axel Gillius Aloumba, Aude Kanga Okandzé, Yanichka Voumbo-Mavoungou, Alphonse Gathsé. (2020). Evolutionary Profile of Cellulitis and Erysipelas of Lower Limbs in a Level-Two Healthcare Facility in Brazzaville, Congo. International Journal of Infectious Diseases and Therapy, 5(1), 4-8. https://doi.org/10.11648/j.ijidt.20200501.12

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    ACS Style

    Edith Sophie Bayonne-Kombo; Axel Gillius Aloumba; Aude Kanga Okandzé; Yanichka Voumbo-Mavoungou; Alphonse Gathsé. Evolutionary Profile of Cellulitis and Erysipelas of Lower Limbs in a Level-Two Healthcare Facility in Brazzaville, Congo. Int. J. Infect. Dis. Ther. 2020, 5(1), 4-8. doi: 10.11648/j.ijidt.20200501.12

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    AMA Style

    Edith Sophie Bayonne-Kombo, Axel Gillius Aloumba, Aude Kanga Okandzé, Yanichka Voumbo-Mavoungou, Alphonse Gathsé. Evolutionary Profile of Cellulitis and Erysipelas of Lower Limbs in a Level-Two Healthcare Facility in Brazzaville, Congo. Int J Infect Dis Ther. 2020;5(1):4-8. doi: 10.11648/j.ijidt.20200501.12

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  • @article{10.11648/j.ijidt.20200501.12,
      author = {Edith Sophie Bayonne-Kombo and Axel Gillius Aloumba and Aude Kanga Okandzé and Yanichka Voumbo-Mavoungou and Alphonse Gathsé},
      title = {Evolutionary Profile of Cellulitis and Erysipelas of Lower Limbs in a Level-Two Healthcare Facility in Brazzaville, Congo},
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {5},
      number = {1},
      pages = {4-8},
      doi = {10.11648/j.ijidt.20200501.12},
      url = {https://doi.org/10.11648/j.ijidt.20200501.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20200501.12},
      abstract = {Background: Cellulitis/erysipelas are the most frequent reason for hospitalization in dermatology departments. Objective: To describe evolutionary profile of cellulitis/erysipelas and to determine associated factors with the long hospital stay. Methods: This was a cross-sectional study carried out from January 2016 to December 2018 in Talangaï Reference Hospital, that included patients hospitalized for cellulitis or erysipelas of the lower limbs. Necrotizing fasciitis cases were excluded. A hospital stay of more than 11 days was considered long. Sociodemographic, clinical and biological data were collected and processed with Epi Info 7.2.1.0. The Chi-square and Fisher tests were used for univariate analysis. Logistic regression was used for multivariate analysis. Results: One hundred and five patients were included, with an average age of 50.7 (±15) years. They were 26 (24.8%) men and 79 (74.2%) women. Antibiotic regimen used was amoxicillin in 19 (18.1%) cases, amoxicillin / clavulanic acid in 40 (38.1%) cases and ceftriaxone in 46 (43.8%) cases. The outcome was favorable in 69 (65.7%) patients. Fever persisted after 5 days-treatment in 19 (28.3%) patients out of 67 initially. Complications were cutaneous necrosis in 19 (18.0%) cases, abscess in 14 (13.3%) cases, severe sepsis and necrotizing fasciitis in 7 and 4 cases, respectively. Two patients died. The average length of hospital stay was 13 days (±7.5) and 44 (41.9%) cases had a long hospital stay. The bullous forms of cellulitis/erysipelas [aOR=4.8, 95%CI (1.9-12.4); p=0.001] and the occurrence of complications [aOR=3.2, 95%CI (1.1-8.7); p=0.026] were associated with a long hospital stay. Conclusion: Cellulitis and erysipelas are potentially serious. Despite treatment, complications can occur, including necrosis and abscess. Effective management, including early medical treatment, daily thorough monitoring of patients, appropriate local care and collaboration with surgeons, is necessary to improve the prognosis of the disease.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Evolutionary Profile of Cellulitis and Erysipelas of Lower Limbs in a Level-Two Healthcare Facility in Brazzaville, Congo
    AU  - Edith Sophie Bayonne-Kombo
    AU  - Axel Gillius Aloumba
    AU  - Aude Kanga Okandzé
    AU  - Yanichka Voumbo-Mavoungou
    AU  - Alphonse Gathsé
    Y1  - 2020/02/19
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijidt.20200501.12
    DO  - 10.11648/j.ijidt.20200501.12
    T2  - International Journal of Infectious Diseases and Therapy
    JF  - International Journal of Infectious Diseases and Therapy
    JO  - International Journal of Infectious Diseases and Therapy
    SP  - 4
    EP  - 8
    PB  - Science Publishing Group
    SN  - 2578-966X
    UR  - https://doi.org/10.11648/j.ijidt.20200501.12
    AB  - Background: Cellulitis/erysipelas are the most frequent reason for hospitalization in dermatology departments. Objective: To describe evolutionary profile of cellulitis/erysipelas and to determine associated factors with the long hospital stay. Methods: This was a cross-sectional study carried out from January 2016 to December 2018 in Talangaï Reference Hospital, that included patients hospitalized for cellulitis or erysipelas of the lower limbs. Necrotizing fasciitis cases were excluded. A hospital stay of more than 11 days was considered long. Sociodemographic, clinical and biological data were collected and processed with Epi Info 7.2.1.0. The Chi-square and Fisher tests were used for univariate analysis. Logistic regression was used for multivariate analysis. Results: One hundred and five patients were included, with an average age of 50.7 (±15) years. They were 26 (24.8%) men and 79 (74.2%) women. Antibiotic regimen used was amoxicillin in 19 (18.1%) cases, amoxicillin / clavulanic acid in 40 (38.1%) cases and ceftriaxone in 46 (43.8%) cases. The outcome was favorable in 69 (65.7%) patients. Fever persisted after 5 days-treatment in 19 (28.3%) patients out of 67 initially. Complications were cutaneous necrosis in 19 (18.0%) cases, abscess in 14 (13.3%) cases, severe sepsis and necrotizing fasciitis in 7 and 4 cases, respectively. Two patients died. The average length of hospital stay was 13 days (±7.5) and 44 (41.9%) cases had a long hospital stay. The bullous forms of cellulitis/erysipelas [aOR=4.8, 95%CI (1.9-12.4); p=0.001] and the occurrence of complications [aOR=3.2, 95%CI (1.1-8.7); p=0.026] were associated with a long hospital stay. Conclusion: Cellulitis and erysipelas are potentially serious. Despite treatment, complications can occur, including necrosis and abscess. Effective management, including early medical treatment, daily thorough monitoring of patients, appropriate local care and collaboration with surgeons, is necessary to improve the prognosis of the disease.
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Department of Medicine, Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo; Department of Dermatology and Infectious Diseases, Talanga? Reference Hospital, Brazzaville, Congo

  • Department of Medicine, Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo; Department of Infectious Diseases, Teaching Hospital, Brazzaville, Congo

  • Department of Dermatology and Infectious Diseases, Talanga? Reference Hospital, Brazzaville, Congo

  • Department of Dermatology and Infectious Diseases, Talanga? Reference Hospital, Brazzaville, Congo

  • Department of Medicine, Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

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