Erysipelas following breast cancer surgery: 12 case reports

Abstract

Objective To analyze clinical and bacteriological features and therapeutic methods of erysipelas following breast cancer surgery in 12 hospitalized patients. Methods Clinical data on 12 patients with erysipelas following breast cancer surgery were collected from 3 third-grade class-A hospitals in Ningbo. A retrospective study was carried out. Results Of the 12 patients, 8 were treated with modified radical mastectomy and axillary lymph node dissection, 3 with radical mastectomy and axillary lymph node dissection, and 1 with mammectomy only. All of the 12 patients suffered from postoperative lymphedema on the affected side. Erysipelas mostly occurred within 1 -18 years (mean, 8.0 years) after breast cancer surgery, and on the same side of surgery in all the patients except 2 with multi-site infection. Specifically speaking, erysipelas was located in the upper extremity in 8 patients, in the chest wall in 1 patient, in the lower extremity in 1 patient. Blood culture was performed for 5 patients, of whom, 2 showed positive results, including 1 infected with Streptococcus equisimilis and 1 with Klebsiella pneumonia. Six patients were treated with penicillins, but the primary treatment failed in 2 patients. After replacement of antibiotics, all the 12 patients experienced an improvement of the condition and were discharged from hospital. Conclusions Patients who suffer from lymphedema after breast cancer surgery are prone to erysipelas of the upper limbs and chest wall. Caution should be taken against gram-negative bacterial infections in these pateints. The treatment of lymphedema should be taken into account besides antibiotic therapy. Key words: Erysipelas; Breast neoplasms; Lymphedema; Lymph node excision; Postoperative complications