Evidence of streptococcal origin of acute non-necrotising cellulitis: a serological study.
Bacteriological diagnosis is rarely achieved in acute cellulitis. Beta-haemolytic streptococci and Staphylococcus aureus are considered the main pathogens. The role of the latter is, however, unclear in cases of non-suppurative cellulitis. We conducted a serological study to investigate the bacterial aetiology of acute non-necrotising cellulitis. Anti-streptolysin O (ASO), anti-deoxyribonuclease B (ADN) and anti-staphylolysin (ASTA) titres were measured from acute and convalescent phase sera of 77 patients hospitalised because of acute bacterial non-necrotising cellulitis and from the serum samples of 89 control subjects matched for age and sex. Antibiotic treatment decisions were also reviewed. Streptococcal serology was positive in 53 (69%) of the 77 cases. Furthermore, ten cases without serological evidence of streptococcal infection were successfully treated with penicillin. Positive ASO and ADN titres were detected in ten (11%) and three (3%) of the 89 controls, respectively, and ASTA was elevated in three patients and 11 controls. Our findings suggest that acute non-necrotising cellulitis without pus formation is mostly of streptococcal origin and that penicillin can be used as the first-line therapy for most patients.
Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, 33521, Tampere, Finland, matti.karppelin@uta.fi.
M
M
Karppelin
T
T
Siljander
A-M
AM
Haapala
J
J
Aittoniemi
R
R
Huttunen
J
J
Kere
J
J
Vuopio
J
J
Syrjänen
D000907:Antibodies, Bacterial / Q000097:blood*; D001426:Bacterial Proteins / Q000276:immunology; D016022:Case-Control Studies; D002481:Cellulitis / Q000188:drug therapy / Q000382:microbiology*; D003851:Deoxyribonucleases / Q000276:immunology*; D004731:Endotoxins / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013301:Streptolysins / Q000276:immunology*; D016896:Treatment Outcome
D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D004731:Endotoxins; D010406:Penicillins; D013301:Streptolysins; C025964:streptolysin O; C016110:staphylolysin; D003851:Deoxyribonucleases; C020069:deoxyribonuclease B