Recurrent Cellulitis - genital area … therefore Trimethoprim 100mg

[GreenFox]

I’ve had single leg Lymphoedema for 15 years now and this has been well-managed with stockings, exercise and skin care etc.

Recently I’ve had monthly cellulitis attacks that always start in the genital area and spread a little. I carry Penicillin and this clears it up within 24 hours (therefore mild?). I finish the 2 weeks course each time.

The cause of the cellulitis in this area is unknown.

So I’m starting a prophylaxis and a single Trimethoprim 100mg at night is recommended, long term.

There is no need for additional Penicillin V prophylaxis unless there are clear (separate) recurrent episodes of (lower) leg cellulitis as well.

Does anyone have experience of this symptom or treatment?

Many thanks in advance.

[Lynora]

Several of my clients are on a similar regime due to recurring cellulitis, but take a higher daily prophylactic dose. If you are having monthly ‘breakthrough’ episodes, perhaps your meds need adjusting?

[GreenFox in reply to Lynora]

Are you saying a higher daily dose of Trimethoprim? I think that 100mg is the recommended prophylactic for this. I know that for the other Penicillin the daily prophylactic dose is higher.

I haven't started yet and so I'll see how it goes - hopefully it will protect enough.

(my BMI is 20)

[CCT67]

My Cellulitis was starting in my groin with no obvious cuts to the skin. It’s thought the infection was starting via a hair follicle. I stopped shaving all together in 2016. I had been using an electric razor after my first Cellulitis episode. Since discontinuing shaving I’ve not had any further Cellulitis episodes, perhaps because as I do not have all the in-grown hairs that I had when I shaved.

I do carry an ‘in case’ two week supply of antibiotics with me as I didn’t want to take them daily. If I have another episode I will take them daily going forward which is ordinarily the practice after two Cellulitis episodes. There are many lymphies who are on a regime like yours

[Stephieh22]

Hi there, I've have Lymphedema in my groin and upper left leg for 6 years now after cancer treatment and like you manage with mld, stockings etc. In the last 2 years I've had 7 episodes of cellulitis which always starts systemically for me (feeling very unwell) then within 24 hours the rash appears in my groin and spreads around the area of lymphedema. I've been hospitalised a few times on IV antibiotics and always have oral antibiotics at the ready. There are never any cuts to the skin. What I eventually realised is that the symptoms always start within 12 to 24 hours of having intercourse! :-(. My consultant believes that the 'trauma' to the area allows bacteria to enter internally. There seems to have been one study done on this and its called 'streptococcal sex syndrome', which I found thanks to Dr Google, but no one else I've spoken to seems to have dealt with anyone with cellulitis triggered this way. The only option I'm being given is to take two years of prophylactic antibiotics, after which time I'll be back to square one again and will be just as susceptible to cellulitis again. I feel at a loss as to what to do! I have huge empathy with anyone dealing with recurrent cellulitis, it's no fun!