Department of Infectious Diseases, 42597Instituto Nacional de Cancerología (INCan), México.
Int J STD AIDS. 2022 Mar;33(3):296-303. doi: 10.1177/09564624211059359. Epub 2021 Dec 30.
Chronic Lower Limb Lymphedema (CL-LL) secondary to Kaposi sarcoma (KS) has not been recognized as a risk factor for cellulitis. The aim was to describe the clinical spectrum and use of antimicrobial prophylaxis in patients with cellulitis and CL-LL due to KS.
HIV patients with KS, CL-LL, and at least one episode of cellulitis seen at the AIDS Cancer Clinic at INCan in Mexico from 2004 to 2019 were included. Demographic and clinical data were obtained from medical records.
Thirty-nine men all with CL-LL were included. Clinical factors associated with cellulitis were groin and/or lymph-node KS infiltration (69.2%), onychomycosis and/or tinea pedis (44.7%), ulcerated lesions (38.4%), and obesity (2.5%). Eighteen (46.1%) were hospitalized in the first episode and eight (20.5%) in recurrence. Six (25.3%) died, two of toxic shock syndrome (TSS), and one of septic shock. Fourteen (35.8%) had at least one recurrent episode of cellulitis. Twenty-five (64.1%) received prophylaxis. Patients without prophylaxis had significantly more unfavorable outcomes (hospitalization and recurrences) than those with prophylaxis.
CL-LL due to KS is a risk factor for cellulitis and severe complications in patients with a long life expectancy. Antimicrobial prophylaxis needs to be explored as it could prevent complications.
卡波西肉瘤（KS）引起的慢性下肢淋巴水肿（CL-LL）尚未被认为是蜂窝织炎的危险因素。本研究旨在描述因 KS 导致 CL-LL 并发蜂窝织炎的患者的临床特征谱和抗菌预防的使用情况。
纳入 2004 年至 2019 年期间在墨西哥 INCan 的艾滋病癌症诊所就诊的患有 KS、CL-LL 且至少发生过一次蜂窝织炎的 HIV 患者。从病历中获取人口统计学和临床数据。
共纳入 39 名男性患者，均患有 CL-LL。与蜂窝织炎相关的临床因素包括腹股沟和/或淋巴结 KS 浸润（69.2%）、甲真菌病和/或足癣（44.7%）、溃疡性病变（38.4%）和肥胖症（2.5%）。18 名（46.1%）患者在首次发作时住院，8 名（20.5%）在复发时住院。6 名（25.3%）患者死亡，其中 2 名死于中毒性休克综合征（TSS），1 名死于感染性休克。14 名（35.8%）至少有一次反复发作的蜂窝织炎。25 名（64.1%）患者接受了预防治疗。未接受预防治疗的患者住院和复发的不良结局明显多于接受预防治疗的患者。
KS 引起的 CL-LL 是具有较长预期寿命的患者发生蜂窝织炎和严重并发症的危险因素。需要探索抗菌预防措施，因为它可以预防并发症。
