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Association With Superficial Fungal Infection in Saphenous Venectomy Limbs

Larry M. Baddour, MD; Alan L. Bisno, MD

JAMA. 1984;251(8):1049-1052.

Abstract
Certain patients who have undergone coronary artery bypass grafts suffer from episodes of acute cellulitis, often repeatedly, in the saphenous vein donor extremity. We describe nine patients with this entity, five of whom suffered recurrent attacks (range, two to >20). The mean interval between surgery and the initial bout of cellulitis was 15 months (range, two to 46 months). A characteristic clinical syndrome was present in the majority of patients that included the abrupt onset of chills, followed by fever (generally >38.8 °C), prostration, and obvious cellulitis. Seven patients also suffered from tinea pedis; in two instances, measures to control the dermatophytosis were instituted and attacks ceased. The pathogenesis of the entity may involve complex interactions between fungal and bacterial agents. Factors such as direct bacterial infection, hypersensitivity to streptococcal exotoxins, and id reactions to dermatophytes are probably involved in varying combinations.

(JAMA 1984;251:1049-1052)

Author Affiliations
From the Division of Infectious Diseases, Department of Medicine, University of Tennessee Center for the Health Sciences, Memphis.

Footnotes
Reprint request to University of Tennessee, Division of Infectious Diseases, 956 Court Ave, 3H16, Memphis, TN 38163 (Dr Baddour).

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