Infection persisting or arising in the course of lymphedema is a serious complication. The isolation of responsible bacteria and the extended use of antibiotics lead to effective control and some diminution in swelling. Amputation of one elephantiasic limb was required for final control. In a second group, often named "pseudoerysipelas," with or without lymphedema, recurrent inflammation and fever are present but bacteria cannot be isolated. While infection is not ruled out, an immune response to microorganisms is suggested by a usually low white blood cell count and the variety of lesions seen in the few biopsies performed. Further attacks have sometimes been prevented by eradicating portals of entry in the feet.
Edwards EA. Recurrent Febrile Episodes and Lymphedema. JAMA. 1963;184(11):858-862. doi:10.1001/jama.1963.03700240050007