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Value of Ultrasound-Guided Biopsy in the Bacteriologic Diagnosis of Cellulitis

연조직염의 세균학적 진단에서 초음파 유도하 생검의 가치

  • 허식 (대학원 의학과 영상의학과학전공)

초록/요약

Purpose: Conventional methods including blood cultures and needle aspiration to identify the causative agents of bacterial cellulitis has shown unsatisfactory results and treatment mainly relies on empirical antibiotics. We investigated the diagnostic value of ultrasound-guided tissue biopsy allowing direct visualization of the most involved area in the demris and hypodermis. Material and Methods: Fifty seven patients who were suspected of cellulitis in the lower limbs and underwent ultrasound-guided biopsy were evaluated, between August 2006 and June 2009. The mean age was 50.6 years; male-female sex ratio was 41:16 (2.6). Ultrasound-guided biopsy was done at the subcutaneous area with most severe inflammatory changes. Among them, blood cultures and fine needle aspiration was also done in 51 and 28 subjects, respectively. Results: The causative organism involved with cellulitis was indentified in 33.3% (19/57). The positive yield rate of ultrasound-guided biopsy, needle aspiration, and blood culture were 22.8% (13/57), 42.9% (12/28), and 5.9% (3/51), respectively. Adding ultrasound-guided biopsy to blood culture and fine needle aspiration results increased the positive yield rate from 5.9% to 21.6%, and 42.9% to 50.0%, respectively. Ultrasound-guided biopsy also identified pathogens in 5 cases where fine needle aspiration was not feasible. Conclusion: Ultrasound-guided biopsy leads to an increase in the positive yield rate of establishing a bacteriological diagnosis for cellulitis, when combined with blood culture and fine needle aspiration. It may be useful especially in patients with unfeasible /negative fine needle aspiration or blood culture results.

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목차

Abstract i
Introduction 1
Materials and Methods 3
Results 6
Discussion 9
Conclusion 13
References 14

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