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Non-Group A Streptococcus CellulitisAka: Non-Group A Strep Cellulitis

Pathophysiology
1. Caused by Non-Group A Beta Hemolytic Streptococcus
Predisposing Conditions
1. Coronary Artery Bypass with saphenous vein graft
  1. Cellulitis extends along saphenous venectomy course
  2. Often recurrent Cellulitis episodes
  3. Associated with Lymphedema and Venous Insufficiency
  4. Tinea Pedis often allows portal of entry
2. Radical pelvic surgery, radiation or Pelvic node cancer
  1. Involves vulva, inguinal areas, and bilateral legs
  2. Recurrent episodes associated with recent coitus
Signs
1. Lymphangitis
2. Recurrent Cellulitis
Differential Diagnosis
1. Erysipelas
2. Other Cellulitis etiologies
Management
1. See Cellulitis
2. Treat underlying fungal infection if present
  1. Miconazole
  2. Clotrimazole
Prevention
1. Pretreat fungal infection if present prior to Surgery
  1. Tinea Pedis prior to CABG with saphenous vein graft
  2. Vaginal Candidiasis prior to pelvic surgery

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.