To the Editor.—
In the recent article, "Recurrent Cellulitis After Coronary Bypass Surgery: Association With Superficial Fungal Infection in Saphenous Venectomy Limbs," Baddour and Bisno1 speculate that the pathogenesis of this syndrome may involve complex interactions between fungal and bacterial agents since the majority of their patients (seven of nine) had tinea infection. We would like to add that in the last two years we have seen two additional patients with this syndrome. One patient (a 51-year-old man with six recurrent episodes of cellulitis within two years of coronary artery bypass graft [CABG] surgery) had tinea infection. However, the second patient (a 60-year-old man with cellulitis in the venectomy site 50 months after CABG surgery) did not have tinea infection but rather had psoriasis involving the dorsal aspect of his foot just distal to the area of cellulitis. Like Baddour and Bisno, we were unable to isolate bacteria from
File TM, Tan JS, Maseelall EA, Snyder RO. Recurrent Cellulitis After Bypass Surgery Associated With Psoriasis. JAMA. 1984;252(13):1681. doi:10.1001/jama.1984.03350130013007
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