Cellulitis and the occult diabetic.
BACKGROUND
Occult diabetes may be an important factor in the development of cellulitis and cellulitis may act as a precipitant to the diagnosis of diabetes mellitus. The present study defines the prevalence of diabetes and glucose tolerance impairment in a group presenting with cellulitis to a teaching hospital. A description of the demographic and pathological presentation of the group is undertaken.


METHODS
Five hundred consecutive admissions for cellulitis to a Sydney teaching hospital were analysed. The cases presented between 1985 and 1994. Precipitating factors, length of stay, site of infection, white cell count, degree of fever, blood sugar estimation, history of diabetes mellitus and microbiological diagnosis were recorded.


RESULTS
Forty-nine patients had a prior diagnosis of diabetes mellitus. Twenty-one percent of patients (56/265) were noted to have abnormal glucose tolerance on routine testing. Thirty-seven per cent of the 1994 cohort (14/38) demonstrated abnormal glucose tolerance. The most common precipitant was trauma (137/500). Mean length of stay was 8.7 days. Microbiological diagnosis was made in 32% of cases.


CONCLUSIONS
Cellulitis requiring admission to hospital is a significant problem in terms of cost and bed occupation. A presentation with cellulitis may be a clinical indicator of impaired glucose tolerance. All patients presenting with cellulitis should have a fasting blood sugar level determined as part of routine workup.
Harris
R A
RA
Department of Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Hardman
D T
DT
Brown
A R
AR
D000328:Adult; D001509:Bed Occupancy; D001786:Blood Glucose / Q000032:analysis; D002481:Cellulitis / Q000175:diagnosis* / Q000191:economics / Q000382:microbiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D017721:Hospital Costs; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010343:Patient Admission; D015995:Prevalence; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000150:complications
D001786:Blood Glucose