PDF(Pubmed)
Abstract：
Bilateral lower extremity inflammatory lymphedema (BLEIL) is a novel condition characterized by confluent erythema and painful edema prominent to the dorsum of the feet and ankles bilaterally following prolonged standing and marching, occurring most often in military recruits. Prolonged standing during the initial week of basic training is thought to cause venous congestion and subsequent inflammatory vasculitis. This condition may be misdiagnosed as bilateral cellulitis, prompting the initiation of unnecessary antibiotic therapy. Increased education and recognition of this new clinical entity would lead to the initiation of appropriate therapy and earlier symptom resolution and, thus, an earlier return to military training. Herein, we describe a small case series of Marine Corps recruit members undergoing their first week of basic training (i.e., \"processing week\") who developed bilateral lower extremity edema, erythema, and pain localized to the dorsum of the feet and the medial and lateral aspects of the ankles consistent with the diagnosis of BLEIL but were initially diagnosed with bilateral lower extremity cellulitis and received intravenous antimicrobial therapy. With prompt initiation of venous decongestive therapy with leg elevation, both patients had rapid symptom resolution and returned to basic training without any future episodes of symptoms. These cases add to the paucity of data on this clinical entity, illustrate the symptoms and demographics of BLEIL, and describe the importance of recognition and initiation of appropriate therapy.
摘要：
双侧下肢炎性淋巴水肿（BLEIL）是一种新颖的疾病，其特征是长时间站立和行进后，双脚和脚踝背侧出现融合的红斑和疼痛性水肿，最常见于新兵。在基础训练的最初一周中长时间站立被认为会导致静脉充血和随后的炎性血管炎。这种情况可能被误诊为双侧蜂窝织炎，促使开始不必要的抗生素治疗。对这种新临床实体的教育和认可的增加将导致开始适当的治疗和更早的症状解决，因此，较早恢复军事训练。在这里，我们描述了一系列小型海军陆战队新兵正在接受第一周基本培训的情况(即，“处理周”)出现双侧下肢水肿的人，红斑,与BLEIL诊断一致,但最初诊断为双侧下肢蜂窝织炎,并接受静脉抗菌治疗。随着腿部抬高迅速开始静脉充血治疗，这两名患者症状缓解迅速,并恢复到基础训练,未来没有出现任何症状.这些病例增加了该临床实体的数据匮乏，说明BLEIL的症状和人口统计学，并描述识别和开始适当治疗的重要性。
