Clinical and Microbiologic Findings in Cellulitis in Thai Patients
KANOKVALAI KULTHANAN, M.D.*, AlMON SIRIPORN, M.D.*, PUAN SUTHIPINITTHARM, M.D.*, PATCHAREE SUNTHONPALIN, M.D.* YONG RONGRUNGRUANG, M.D.**, WARANYA BOONCHAI, M.D.*, APICHATI SIVAYATHORN, M.D.*,
Affiliation : * Department of Dermatology, ** Infectious Division, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University. Bangkok 10700, Thailand.
Background : Cellulitis is an inflammation of subcutaneous tissue in which infective,
generally bacterial cause is proven or assumed. However, attempts to culture bacteria from lesions
are often unsuccessful.
Method : One hundred and fifty cases diagnosed as cutaneous cellulitis at Siriraj Hospital
between 1992 and 1995 were retrospectively studied.
Results : Our study in 150 adult Thai patients with cellulitis showed that the most common
site of infection was the lower extremity. Forty two per cent of the patients had history of preceding
local trauma. Fever and regional lymphadenopathy were detected in 77.3 per cent and 22.6 per cent
respectively. Sixty nine per cent of patients had leukocytosis with a mean neutrophil ratio of 79.7
per cent of patients with underlying diseases predisposed to the infection, 61.6 per cent had positive
lesional culture results in contrast to 31.6 per cent in patients without. Needle aspiration and blood
gave low positive culture yields. The common organisms detected were S.aureus and Strepto-
coccus group A (83%) in immunocompetent patients. Of immunocompromised patients, in one half
of the cases gram negative bacteria were found.
Conclusions : This study showed that in immunocompetent patients, the major bacterial
isolated in cellulitis were S.aureus and Streptococcus group A. In immunocompromised patients,
gram negative bacteria were found in one half. These findings may help in the selection of antimi-
crobials before the results of bacterial cultures are available or in culture negative cases.
Keywords : Cellulitis, Clinical Features, Microbiologic Study
