{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:51:09Z","timestamp":1789527069680,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2016,11,11]],"date-time":"2016-11-11T00:00:00Z","timestamp":1478822400000},"content-version":"vor","delay-in-days":352,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Department of Clinical Science, University of Bergen, Norway"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background. \u2003The importance of bacteria other than group A streptococci (GAS) in different clinical presentations of cellulitis is unclear, commonly leading to treatment with broad-spectrum antibiotics. The aim of this study was to describe the etiological and clinical spectrum of cellulitis and identify clinical features predicting streptococcal etiology.<\/jats:p>\n                  <jats:p>Methods. \u2003We prospectively enrolled 216 patients hospitalized with cellulitis. Clinical details were registered. Bacterial culture was performed from blood, cutaneous or subcutaneous tissue, and\/or swabs from skin lesions. Paired serum samples were analyzed for anti-streptolysin O and anti-deoxyribonuclease B antibodies.<\/jats:p>\n                  <jats:p>Results. \u2003Serology or blood or tissue culture confirmed \u03b2-hemolytic streptococcal (BHS) etiology in 72% (146 of 203) of cases. An additional 13% (27 of 203) of cases had probable BHS infection, indicated by penicillin response or BHS cultured from skin swabs. \u03b2-hemolytic streptococcal etiology was predominant in all clinical subgroups, including patients without sharply demarcated erythema. \u03b2-hemolytic group C or G streptococci (GCS\/GGS) were more commonly isolated than GAS (36 vs 22 cases). This predominance was found in the lower extremity infections. Group C or G streptococci in swabs were associated with seropositivity just as often as GAS. Staphylococcus aureus was cultured from swabs as a single pathogen in 24 cases, 14 (64%) of which had confirmed BHS etiology. Individual BHS-associated clinical characteristics increased the likelihood of confirmed BHS disease only slightly; positive likelihood ratios did not exceed 2.1.<\/jats:p>\n                  <jats:p>Conclusions. \u2003\u03b2-hemolytic streptococci were the dominating cause of cellulitis in all clinical subgroups and among cases with S aureus in cutaneous swabs. Group C or G streptococci were more frequently detected than GAS. No single clinical feature substantially increased the probability of confirmed BHS etiology.<\/jats:p>","DOI":"10.1093\/ofid\/ofv181","type":"journal-article","created":{"date-parts":[[2016,1,11]],"date-time":"2016-01-11T20:25:11Z","timestamp":1452543911000},"source":"Crossref","is-referenced-by-count":71,"title":["Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study"],"prefix":"10.1093","volume":"3","author":[{"given":"Trond","family":"Bruun","sequence":"first","affiliation":[{"name":"Department of Clinical Science, University of Bergen"},{"name":"Departments of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oddvar","family":"Oppegaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen"},{"name":"Departments of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e5rd R.","family":"Kittang","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen"},{"name":"Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haima","family":"Mylvaganam","sequence":"additional","affiliation":[{"name":"Microbiology, Haukeland University Hospital, Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Langeland","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen"},{"name":"Departments of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steinar","family":"Skrede","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen"},{"name":"Departments of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,11,25]]},"reference":[{"key":"2020081005265501400_OFV181C1","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1093\/cid\/ciu296","article-title":"Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America","volume":"59","author":"Stevens","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2020081005265501400_OFV181C2","first-page":"1195","article-title":"Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections","volume-title":"Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases","author":"Pasternack","year":"2014","edition":"8th ed"},{"key":"2020081005265501400_OFV181C3","doi-asserted-by":"crossref","first-page":"163.e1","DOI":"10.1016\/j.jaad.2012.03.024","article-title":"Lower limb cellulitis and its mimics: Part I. 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