Nazife Duygu DEMİRBAŞ, Özlem GÜL, Ceren Atasoy TAHTASAKAL, Nuray UZUN, Dilek Yıldız SEVGİ, İlyas DÖKMETAŞ
Cam and Sakura Medical Journal - 2026;6(1):1-8
Objective: This study aimed to evaluate the clinical, microbiological, and sociodemographic characteristics of patients diagnosed with cellulitis and to identify risk factors associated with the development of recurrence. Material and Methods: This retrospective, single-center observational study included 120 adult patients (aged >=18 years) treated for cellulitis as inpatients or outpatients over a one-year period. Demographic, clinical, and laboratory data were extracted from electronic medical records. Predisposing factors, infection sites, treatment characteristics, and variables associated with recurrence were evaluated. Recurrence was defined as a history of at least two episodes of lower extremity cellulitis. Univariable and multivariable logistic regression analyses were performed to identify factors associated with recurrence. Statistical significance was set at a p value <0.05. Results: Among the 120 patients diagnosed with cellulitis, the mean age was 56.4+/-15.7 years; 51% were male. The most commonly affected site was the lower extremity (91%). Although all patients presented with edema and erythema, increased local temperature (96%) and pain (80%) were also frequent findings, whereas fever was less common (15%). The most prevalent predisposing factors were tinea pedis (64.2%), obesity (56.7%), and onychomycosis (47.5%). The recurrence rate was 36.7%. Statistically significant associations were found between recurrence and advanced age, lymphedema, peripheral arterial disease, higher body mass index (BMI), and living alone or being homeless (p<0.05). In multivariable logistic regression analysis, living alone or being homeless [odds ratio (OR): 6.27, 95% confidence interval (CI): 1.36-28.87, p=0.018], older age (OR: 1.03 per year, 95% CI: 1.001-1.06, p=0.045), and the presence of lymphedema (OR: 3.08, 95% CI: 1.17-8.14, p=0.023) were independently associated with recurrence, while BMI showed a borderline association (OR: 1.06, 95% CI: 0.99-1.14, p=0.084). Additionally, C-reactive protein levels were positively correlated with duration of antibiotic treatment and length of hospital stay. Conclusion: The findings suggest that cellulitis recurrence is closely associated not only with the treatment of the acute infection but also with the comprehensive management of underlying chronic conditions. In particular, controlling modifiable risk factors such as lymphedema, peripheral arterial disease, and higher BMI may play a crucial role in reducing recurrence rates. These results highlight the importance of risk-based and individualized approaches in clinical management.
