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Original Research |

Recurrent Cellulitis After Saphenous Venectomy for Coronary Bypass Surgery

[+] Article, Author, and Disclosure Information

Grant support: in part by research grant AI-10085-17, National Institute of Allergy and Infectious Diseases.

▸Requests for reprints should be addressed to Alan L. Bisno, M.D.; University of Tennessee Center for the Health Sciences, Department of Medicine, Division of Infectious Diseases; 956 Court Avenue, 3H16 Coleman; Memphis, TN 38163.

Memphis, Tennessee

© 1982 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1982;97(4):493-496. doi:10.7326/0003-4819-97-4-493
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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.





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