Cellulitis in Chronic Liver Disease in Tertiary Care Centre in South India

Background and Aim: Cellulitis represents a significant complication in patients with chronic liver disease. This study aimed to investigate the incidence, clinical characteristics, and microbiological profile of cellulitis in patients with chronic liver disease at a tertiary care center in South India. Methods: This prospective observational study included 55 patients with chronic liver disease who developed cellulitis between January 2023 and December 2023. Patient demographics, etiology of liver disease, comorbidities, site of infection, microbiological data, and outcomes were analyzed. Results: Among 470 hospitalized cirrhotic patients, 55 (11.7%) developed cellulitis. The mean age was 52.8 ? 10.4 years, with male predominance (88%). Alcohol (45.5%) and NASH (29.1%) were the predominant etiologies of cirrhosis. Most patients had advanced liver disease (Child-Pugh C: 52.7%, B: 43.6%). Diabetes mellitus was the most common comorbidity (40%). Lower limb involvement was predominant (63.6%), with 45.5% showing bilateral involvement. Culture positivity was observed in 52% of cases, with gram-negative organisms predominating. E. coli and Acinetobacter baumannii were the most common isolates, with 61% showing multidrug resistance. The overall mortality rate was 3.6%. Conclusion: Cellulitis is a common complication in chronic liver disease, particularly in advanced stages. Gram-negative organisms with high antimicrobial resistance predominate, emphasizing the need for appropriate empirical antibiotic selection. Early recognition and appropriate management result in favorable outcomes despite the severity of underlying liver disease.