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Thierry Duvanel, MD; Raymond Auckenthaler, MD; Peter Rohner, VD; Monika Harms, MD; Jean H. Saurat, MD

Arch Intern Med. 1989;149(2):293-296.

Abstract
• To study the microbiologic features of cutaneous cellulitis prospectively, quantitative biopsy cultures were carried out in 25 patients who were hospitalized for an untreated cutaneous cellulitis. Biopsy specimens were obtained from both the center and the advancing edge of erythema. Only nine biopsy specimens (three central and six peripheral) (18%) of 50 yielded pathogens. Needle aspiration cultures were performed in seven cases: two yielded pathogens (28.5%). The density of microorganisms was low, ranging from less than 80 colonyforming units (CFUs) per gram of tissue to 1360 CFUs/g of tissue, except next to the edge of an ulcer (two cases), where densities reached 3.2x 10⁶ CFUs/g of tissue. Cutaneous cellulitis shows a discrepancy between the low density of microorganisms and the intensity of the inflammation. A factor other than infection must be implicated. This might be lymphatic failure, which is found in 72% of patients.

(Arch Intern Med 1989;149:293-296)

Author Affiliations
From the Clinic of Dermatology (Drs Duvanel, Harms, and Saurat) and Division of Infectious Diseases (Drs Auckenthaler and Rohner), Department of Medicine, Hôpital Cantonal Universitaire, Geneva.

Footnotes
Accepted for publication Sept 20, 1988.

Reprint requests to Clinic of Dermatology, Department of Medicine, Hôpital Cantonal Universitaire, 1211 Geneva 4, Switzerland (Dr Duvanel).

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