title: Predictors of recurrent cellulitis in five years. Clinical risk factors and the role of PTX3 and CRP.
abstract: OBJECTIVE
  To identify risk factors for recurrence of cellulitis, and to assess the predictive value of pentraxin 3 (PTX3) and C-reactive protein (CRP) measured at baseline.
  
  
  METHODS
  A follow up study of 90 hospitalised patients with acute non-necrotising cellulitis was conducted. Clinical risk factors were assessed and PTX3 and CRP values were measured at baseline. Patients were contacted by phone at a median of 4.6 years after the baseline episode and the medical records were reviewed.
  
  
  RESULTS
  Overall, 41% of the patients had a recurrence in the follow up. Of the patients with a history of a previous cellulitis in the baseline study 57% had a recurrence in five year follow up as compared to 26% of those without previous episodes (p = 0.003). In multivariate analysis, only the history of previous cellulitis was identified as an independent predicting factor for recurrence. The levels of pentraxin 3 (PTX3) or C-reactive protein (CRP) in the acute phase did not predict recurrence.
  
  
  CONCLUSIONS
  Risk of recurrence is considerably higher after a recurrent episode than after the first episode. Clinical risk factors predisposing to the first cellulitis episode plausibly predispose also to recurrences.
authors.affiliation: Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: matti.karppelin@uta.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Karppelin
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, P.O. Box 57, FI-20521 Turku, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Siljander
authors.affiliation: Department of Clinical Microbiology, Fimlab Laboratories, P.O. Box 66, FI-33101 Tampere, Finland.
authors.forename: Janne
authors.initials: J
authors.lastname: Aittoniemi
authors.affiliation: Department of Clinical Microbiology, Fimlab Laboratories, P.O. Box 66, FI-33101 Tampere, Finland; Department of Microbiology and Immunology, School of Medicine, University of Tampere, FI-33014 University of Tampere, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Hurme
authors.affiliation: Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland.
authors.forename: Reetta
authors.initials: R
authors.lastname: Huttunen
authors.affiliation: School of Health Sciences, University of Tampere, FI-33014 University of Tampere, Finland.
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.affiliation: Department of Medical Genetics, University of Helsinki, P.O. Box 33, FI-00014 University of Helsinki, Finland; Department of Biosciences and Nutrition, and Clinical Research Centre, Karolinska Institutet, SE-141 83 Huddinge, Sweden; Science for Life Laboratory, P.O. Box 1031, SE-17121 Solna, Sweden.
authors.forename: Juha
authors.initials: J
authors.lastname: Kere
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, P.O. Box 57, FI-20521 Turku, Finland; Department of Medical Microbiology and Immunology, Medical Faculty, University of Turku, FI-20014 Turun Yliopisto, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Vuopio
authors.affiliation: Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland; Medical School, University of Tampere, FI-33014 Tampereen Yliopisto, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Syrjänen
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D015984:Causality; D002481:Cellulitis / Q000097:blood / Q000382:microbiology; D004886:Erysipelas / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D000683:Serum Amyloid P-Component / Q000032:analysis*; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins
keywords: CRP; Cellulitis; Erysipelas; PTX3; Recurrence