Predictors of recurrent cellulitis in five years. Clinical risk factors and the role of PTX3 and CRP

•Recurrence rate of acute bacterial cellulitis in five years was 41%.•Risk of recurrence in five years was 26% for patients with no previous episodes.•Risk of recurrence was 56% after a recurrent cellulitis episode.•Previous cellulitis predicts recurrence.

SummaryObjectivesTo identify risk factors for recurrence of cellulitis, and to assess the predictive value of pentraxin 3 (PTX3) and C-reactive protein (CRP) measured at baseline.MethodsA follow up study of 90 hospitalised patients with acute non-necrotising cellulitis was conducted. Clinical risk factors were assessed and PTX3 and CRP values were measured at baseline. Patients were contacted by phone at a median of 4.6 years after the baseline episode and the medical records were reviewed.ResultsOverall, 41% of the patients had a recurrence in the follow up. Of the patients with a history of a previous cellulitis in the baseline study 57% had a recurrence in five year follow up as compared to 26% of those without previous episodes (p = 0.003). In multivariate analysis, only the history of previous cellulitis was identified as an independent predicting factor for recurrence. The levels of pentraxin 3 (PTX3) or C-reactive protein (CRP) in the acute phase did not predict recurrence.ConclusionsRisk of recurrence is considerably higher after a recurrent episode than after the first episode. Clinical risk factors predisposing to the first cellulitis episode plausibly predispose also to recurrences.