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Infections, Cellulitis, and Osteomyelitis

  • Silvia Bellando-Randone
  • Gemma Lepri
Chapter

Abstract

Patients with systemic sclerosis (SSc) may present digital ulcers (DUs) that can lead to several complications as infection, cellulitis, and osteomyelitis affecting the quality of life. Infection is a very common complication due to several factors as microangiopathy, defective activity of the immune system, the concomitant immunosuppressive treatments, and the use of contaminated medical equipments. Infection of DU represents the main predisposing condition to bone infection and inflammation (osteomyelitis) frequently accompanied by cellulitis. Laboratory findings and clinical features are important to suspect osteomyelitis, which has then to be confirmed by instrumental investigations. A multidisciplinary team is required (infectivologist, orthopedic surgeon, radiologist, and nuclear medicine physician) for the management of osteomyelitis to avoid further complications.

Keywords

Systemic sclerosis Digital ulcers Infection Osteomyelitis Cellulitis Bone Instrumental examination 

References

  1. 1.
    Steen V, Denton CP, Pope JE, Matucci-Cerinic M. Digitalulcers: overt vascular disease in systemic sclerosis. Rheumatology. 2009;48(Suppl 3):iii19–24.PubMedGoogle Scholar
  2. 2.
    Schiopu E, Impens AJ, Philips K. Digital ischemia in scleroderma spectrum of diseases. Int J Rheumatol. 2010, 2010;  https://doi.org/10.1155/2010/923743.CrossRefGoogle Scholar
  3. 3.
    Gastmeier P, Stamm-Balderjahn S, Hansen S, Nitzschke-Tiemann F, Zuschneid I, Groneberg K, et al. How outbreaks can contribute to prevention of nosocomial infection: analysis of 1,022 outbreaks. Infect Control Hosp Epidemiol. 2005;26:357–61.CrossRefGoogle Scholar
  4. 4.
    Giuggioli D, Manfredi A, Colaci M, Lumetti F, Ferri C. Scleroderma digital ulcers complicated by infection with fecal pathogens. Arthritis Care Res. 2012;64(2):295–7.CrossRefGoogle Scholar
  5. 5.
    Longtin Y, Sax H, Allegranzi B, Schneider F, Pittet D. Handhygiene. N Engl J Med. 2011;364:e24.CrossRefGoogle Scholar
  6. 6.
    Jeffcoate WJ, Lipsky BA. Controversies in diagnosis and managing osteomyelitis of the foot in diabetes. Clin Infect Dis. 2004;39:S115–22.CrossRefGoogle Scholar
  7. 7.
    Ferri C, Valentini G, Cozzi F, Sebastiani M, Michelassi C, LaMontagna G, et al. Systemic sclerosis: demographic, clinical and serologic features and survival in 1,012 Italian patients. Medicine. 2002;81:139–53.CrossRefGoogle Scholar
  8. 8.
    Giuggioli D, Manfredi A, Colaci M, Lumetti F, Ferri C. Osteomyelitis complicating scleroderma digital ulcers. Clin Rheumatol. 2013;32(5):623–7.CrossRefGoogle Scholar
  9. 9.
    Concia E, Prandini N, Massari L, Ghisellini F, Consoli V, Menichetti F, et al. Osteomyelitis: clinical update for practical guidelines. Nucl Med Commun. 2006;27(8):645–60.CrossRefGoogle Scholar
  10. 10.
    Esposito S, Leone S, Bassetti M, Borrè S, Leoncini F, Meani E, et al. Italian guidelines for the diagnosis and infectious disease management of osteomyelitis and prosthetic joint infections in adults. Infection. 2009;37(6):378–496.CrossRefGoogle Scholar
  11. 11.
    Zuluaga AF, Galvis W, Saldarriaga JG, Agudel M, Salazar BE, Vesga O. Etiologic diagnosis of chronic osteomyelitis: a prospective study. Arch Intern Med. 2006;166:95–100.CrossRefGoogle Scholar
  12. 12.
    Pineda C, Vargas A, Rodríguez AV. Imaging of osteomyelitis: current concepts. Infect Dis Clin N Am. 2006;20(4):789–825.CrossRefGoogle Scholar
  13. 13.
    Cranendonk DR, Opmeer BC, Prins JM, Wiersinga WJ. Comparing short to standard duration of antibiotic therapy for patients hospitalized with cellulitis (DANCE): study protocol for a randomized controlled trial. BMC Infect Dis. 2014;14:235.CrossRefGoogle Scholar
  14. 14.
    Swartz MN. Cellulitis. N Engl J Med. 2004;350:904–12.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Silvia Bellando-Randone
    • 1
    • 2
  • Gemma Lepri
    • 1
    • 2
  1. 1.Department of Clinical and Experimental Medicine, University of FlorenceFlorenceItaly
  2. 2.Department of Geriatric Medicine, Division of Rheumatology AOUCFlorenceItaly

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