Schmit J L
Service de Maladies Infectieuses, CHU, 80000 Amiens, France.
Ann Dermatol Venereol. 2001 Mar;128(3 Pt 2):334-7.
771 cases of erysipelas and 52 cases of infectious cellulitis were collected over 3 months in a prospective study carried out in French hospitals. The mean age was 62.7 +/- 19.3 years for the erysipelas patients and 69.7 +/- 16 years for the cellulitis patients. Sex-ratios were respectively 0.92 and 2.7. The infection was mainly localized in the lower limbs in both categories (90.9 p. 100 and 71 p. 100); the upper limbs and the face were more often involved in cellulitis than in erysipelas (13 p. 100 versus 5.2 p. 100 and 10 p. 100 versus 2.5 p. 100). Penicillin G was the initial antimicrobial treatment in 45 p. 100 of the erysipelas cases, whereas amoxicillin-clavulanic acid was used in 32.7 p. 100 of the cellulitis cases. Other antibiotics used were pristinamycin, antistaphylococcal penicillin, and amoxicillin. Combinations of antibiotics were used to treat 50 p. 100 of the cellulitis cases but only 11 p. 100 of the erysipelas cases. Anticoagulants were used in 67.4 p. 100 of the erysipelas cases and in 59.7 p. 100 of the cellulitis cases. Surgery was performed in 52 p. 100 of the cellulitis cases, and hyperbaric oxygen in 4.2 p. 100. The outcome was quite different for the 2 diseases: cure rate without complications reached 86.6 p. 100 for erysipelas, and only 48.1 p. 100 for cellulitis; death rates reached respectively 0.77 p. 100 and 5.7 p. 100, median length of hospitalization 8 days and 21 days, and median length of antibiotic treatment 15 days and 21 days.
在法国医院进行的一项前瞻性研究中,在3个月内收集了771例丹毒病例和52例感染性蜂窝织炎病例。丹毒患者的平均年龄为62.7±19.3岁,蜂窝织炎患者的平均年龄为69.7±16岁。性别比分别为0.92和2.7。两类感染主要都局限于下肢(分别为90.9%和71%);上肢和面部在蜂窝织炎中比在丹毒中更常受累(分别为13%对5.2%和10%对2.5%)。45%的丹毒病例初始抗菌治疗使用青霉素G,而32.7%的蜂窝织炎病例使用阿莫西林 - 克拉维酸。使用的其他抗生素有普那霉素、抗葡萄球菌青霉素和阿莫西林。50%的蜂窝织炎病例使用了联合抗生素治疗,但丹毒病例仅为11%。67.4%的丹毒病例和59.7%的蜂窝织炎病例使用了抗凝剂。52%的蜂窝织炎病例进行了手术,4.2%的病例进行了高压氧治疗。这两种疾病的结果差异很大:丹毒无并发症治愈率达到86.6%,而蜂窝织炎仅为48.1%;死亡率分别为0.77%和5.7%,住院中位时长分别为8天和21天,抗生素治疗中位时长分别为15天和21天。