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Edward W. Hook III, MD; Thomas M. Hooton, MD; Christy A. Horton, MD; Marie B. Coyle, PhD; Paul G. Ramsey, MD; Marvin Turck, MD

Arch Intern Med. 1986;146(2):295-297.

Abstract
• Fifty patients with cellulitis were evaluated prospectively using cultures of aspirates from the advancing edge of cellulitis, skin biopsy specimens, and blood. Potential microbial pathogens were isolated in 13 patients. Biopsy specimen cultures were positive in ten patients, while aspirate and blood cultures were positive in five and two, respectively. Aspirate, biopsy, or blood cultures were more often positive in patients with apparent primary lesions than in patients without such lesions. Apparent primary sites of infection were identified and cultured in 24 patients. β-Hemolytic streptococci were isolated from 17 primary lesions, and coagulase-positive staphylococci were present in 13. Both organisms were isolated from ten primary lesions. Among patients with positive aspirate, biopsy, and/or blood cultures, the same pathogens were also isolated from primary sites in ten of ten patients. Clinical features, including temperature, white blood cell count, and erythrocyte sedimentation rate, were not predictive of positive aspirate, biopsy, or blood cultures. These cultures provided no microbiologic information that was not obtainable from culture of primary lesions.

(Arch Intern Med 1986;146:295-297)

Author Affiliations
From the Departments of Medicine (Drs Hook, Hooton, Horton, Ramsey, and Turck) and Microbiology (Dr Coyle), Divisions of Infectious Diseases (Drs Hook and Turck) and Ambulatory Medicine (Drs Hooton and Ramsey), Harborview Medical Center, and the University of Washington School of Medicine, Seattle. Dr Ramsey is an American College of Physicians' teaching and research scholar. Dr Hook is now with the Division of Infectious Diseases, The Johns Hopkins Hospital, Baltimore.

Footnotes
Accepted for publication May 28, 1985.

Reprint requests to the Division of Infectious Diseases, The Johns Hopkins Hospital, Blalock 1111, Baltimore, MD 21205 (Dr Hook).

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