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February 24, 1984

Recurrent Cellulitis After Coronary Bypass Surgery: Association With Superficial Fungal Infection in Saphenous Venectomy Limbs

Author Affiliations

From the Division of Infectious Diseases, Department of Medicine, University of Tennessee Center for the Health Sciences, Memphis.

JAMA. 1984;251(8):1049-1052. doi:10.1001/jama.1984.03340320035023

Certain patients who have undergone coronary artery bypass grafts suffer from episodes of acute cellulitis, often repeatedly, in the saphenous vein donor extremity. We describe nine patients with this entity, five of whom suffered recurrent attacks (range, two to >20). The mean interval between surgery and the initial bout of cellulitis was 15 months (range, two to 46 months). A characteristic clinical syndrome was present in the majority of patients that included the abrupt onset of chills, followed by fever (generally >38.8 °C), prostration, and obvious cellulitis. Seven patients also suffered from tinea pedis; in two instances, measures to control the dermatophytosis were instituted and attacks ceased. The pathogenesis of the entity may involve complex interactions between fungal and bacterial agents. Factors such as direct bacterial infection, hypersensitivity to streptococcal exotoxins, and id reactions to dermatophytes are probably involved in varying combinations.

(JAMA 1984;251:1049-1052)

Baddour LM, Bisno AL:  Recurrent cellulitis after saphenous venectomy for coronary bypass surgery .  Ann Intern Med 1982;97:493-496.Crossref
Greenberg J, DeSanctis RW, Mills RM Jr:  Vein-donor-leg cellulitis after coronary artery bypass surgery .  Ann Intern Med 1982;97:565-566.Crossref
Marsden PD:  Lymphoreticular filariasis , in Hoeprich PD (ed):  Infectious Diseases . Philadelphia, Harper & Row Publishers Inc, 1983, pp 1282-1285.
Bisno AL:  Postmastectomy edema and recurrent cellulitis .  JAMA 1982;247:3359-3360.Crossref
Birkhaug KE:  Erysipelas: VIII. Bacterial allergy to streptococcus erysipelatis in recurrent erysipelas .  JAMA 1928;90:1997-2001.Crossref
Schlievert PM, Bettin KM, Watson DW:  Reinterpretation of the Dick test: Role of group A streptococcal pyrogenic exotoxin .  Infect Immun 1979;26:467-472.
Young JR, DeWolfe VG:  Recurrent lymphangitis of the leg associated with dermatophytosis .  Cleve Clin Q 1960;27:19-24.Crossref
McGlasson IL:  Recurrent erysipelas of the legs with dermatitis of the feet .  Arch Dermatol 1926;14:679-682.Crossref
Sulzberger MB, Rostenberg A Jr, Goetze D:  Recurrent erysipelas-like manifestations of the legs .  JAMA 1937;108:2189-2193.Crossref
Edwards EA:  Recurrent febrile episodes and lymphedema .  JAMA 1963;184:858-862.Crossref
Naide M:  Allergic lesions following thrombophlebitis .  Arch Intern Med 1947;80:388-396.Crossref
Traub EF, Tolmach JA:  An erysipelas-like eruption complicating dermatophytosis .  JAMA 1937;108:2187-2189.Crossref
Kaplan EL, Bisno AL, Derrick W, et al:  American Heart Association Committee report: Prevention of rheumatic fever .  Circulation 1977; 55( (suppl) ):1A-4A.