Baddour L M, Bisno A L
Ann Intern Med. 1982 Oct;97(4):493-6. doi: 10.7326/0003-4819-97-4-493.
We describe a previously unreported complication of coronary artery bypass grafting, recurrent cellulitis. Five patients had 20 episodes of acute cellulitis, each occurring in the lower extremity in which saphenous venectomy had been done. The cases were striking because the patients presented with high fever and considerable systemic toxicity. The appearance of the lesions, presence in one case of obvious associated lymphangitis, and prompt response in three instances to therapy with penicillin alone all suggest group A streptococcal infection. In one case, a beta-hemolytic, bacitracin-susceptible Streptococcus strain was isolated from the lesion. The pathogenesis of this syndrome remains obscure but, based on our understanding of postsurgical erysipelas, this cellulitis likely results from the interplay of several factors, including local compromise of lymphatic drainage, direct bacterial invasion, and acquired hypersensitivity to streptococcal exotoxins.
我们描述了一种冠状动脉搭桥术先前未报告的并发症——复发性蜂窝织炎。5例患者发生了20次急性蜂窝织炎发作，每次均发生在已进行大隐静脉切除术的下肢。这些病例很引人注目，因为患者表现为高热和相当程度的全身中毒症状。病变的外观、1例明显伴有淋巴管炎以及3例仅用青霉素治疗即迅速起效，均提示为A组链球菌感染。在1例中，从病变部位分离出一株β溶血性、对杆菌肽敏感的链球菌菌株。该综合征的发病机制仍不清楚，但根据我们对术后丹毒的了解，这种蜂窝织炎可能是由多种因素相互作用导致的，包括局部淋巴引流受损、细菌直接入侵以及对链球菌外毒素获得性超敏反应。
