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Neonatal retropharyngeal cellulitis due to group B streptococcus.

Two neonates who presented with histories of poor feeding, irritability and noisy breathing had group B streptococcal (GBS) bacteremia and retropharyngeal cellulitis. One infant also had submandibular cellulitis. Retropharyngeal cellulitis has not been recognized as a manifestation of GBS disease. Evaluation of the upper airway should be part of the workup of any sick infant with noisy breathing and/or grunting. Retropharyngeal tissue enlargement may be an early indicator of GBS disease.

Cellulitis↗

Escherichia coli cellulitis in children with idiopathic nephrotic syndrome.

Although Streptococcus pneumoniae is traditionally considered the preponderant bacterial pathogen in children with nephrotic syndrome, recent data suggest an increase of infections with encapsulated gram-negative organisms. We report two children with idiopathic nephrotic syndrome in relapse who developed spontaneous Escherichia coli cellulitis. The organism was recovered from the cellulitis tissue aspirate of one, and from the blood of the other. Both patients responded to appropriate antibiotic therapy. Initial treatment of sepsis, peritonitis or spontaneous cellulitis in nephrotic patients should include broad spectrum antibiotic coverage pending results of appropriate cultures.

Adolescent↗

A statistical model for assessing sample size for bacterial colony selection: a case study of Escherichia coli and avian cellulitis.

A general problem for microbiologists is determining the number of phenotypically similar colonies growing on an agar plate that must be analyzed in order to be confident of identifying all of the different strains present in the sample. If a specified number of colonies is picked from a plate on which the number of unique strains of bacteria is unknown, assigning a probability of correctly identifying all of the strains present on the plate is not a simple task. With Escherichia coli of avian cellulitis origin as a case study, a statistical model was designed that would delineate sample sizes for efficient and consistent identification of all the strains of phenotypically similar bacteria in a clinical sample. This model enables the microbiologist to calculate the probability that all of the strains contained within the sample are correctly identified and to generate probability-based sample sizes for colony identification. The probability of cellulitis lesions containing a single strain of E. coli was 95.4%. If one E. coli strain is observed out of three colonies randomly selected from a future agar plate, the probability is 98.8% that only one strain is on the plate. These results are specific for this cellulitis E. coli scenario. For systems in which the number of bacterial strains per sample is variable, this model provides a quantitative means by which sample sizes can be determined.

Animals↗

Case report: dental infection leading to orbital cellulitis.

UNLABELLED: Orbital cellulitis is a rare but serious sequel of infection from a dental origin. Without prompt treatment, further spread of infection is likely to occur, resulting in loss of vision and possibly death. We report a case of orbital cellulitis secondary to infection originating in a recently endodontically-treated upper first molar tooth. The case was successfully treated by intravenous antibiotics. CLINICAL RELEVANCE: Odontogenic causes of orbital cellulitis and sinusitis should always be considered in the differential diagnosis. The importance of aggressive treatment of infections in maxillary teeth cannot be over emphasized. Correct diagnosis is vital to the success of therapy.

Adult↗

Recurrent cellulitis after saphenous venectomy for coronary bypass surgery.

We describe a previously unreported complication of coronary artery bypass grafting, recurrent cellulitis. Five patients had 20 episodes of acute cellulitis, each occurring in the lower extremity in which saphenous venectomy had been done. The cases were striking because the patients presented with high fever and considerable systemic toxicity. The appearance of the lesions, presence in one case of obvious associated lymphangitis, and prompt response in three instances to therapy with penicillin alone all suggest group A streptococcal infection. In one case, a beta-hemolytic, bacitracin-susceptible Streptococcus strain was isolated from the lesion. The pathogenesis of this syndrome remains obscure but, based on our understanding of postsurgical erysipelas, this cellulitis likely results from the interplay of several factors, including local compromise of lymphatic drainage, direct bacterial invasion, and acquired hypersensitivity to streptococcal exotoxins.

Adult↗

Understanding and managing cellulitis.

Cellulitis is a relatively common emergency in acute and community care settings, and can be a source of significant pain and anxiety for affected patients. This article examines the management of patients with generalised cellulitis--an infection of the skin and subcutaneous tissues, which is exacerbated by the presence of damaged skin, poor circulation or diabetes mellitus. Appropriate dressing regimens for the management of wounds resulting from this infection are discussed. Localised cellulitis that develops as a result of an existing wound infection is not covered in this article.

Anxiety↗

[Recurrent infectious and metastatic cellulitis cause by Escherichia coli].

BACKGROUND: We report a case of recurrent and metastatic infectious cellulitis caused by Escherichi coli. CASE REPORT: A 79-year-old man with a history of alcoholic cirrhosis and a myelodyplasia syndrome was hospitalized for skin rash and inflammatory edema of the right leg associated with bullous and necrotic lesions. Culture of a bulla puncture fluid grew E. coli. A two-drug intravenous antibiotic regimen and surgical cleansing led to a favorable outcome in 3 weeks. One week after withdrawal of the antibiotics, the patient developed a recurrent erythematous and inflammatory lesion of the right flank. Blood culture grew E. coli. The intravenous antibiotics were reinitiated immediately and provided rapid regression of the skin signs. Search for a urinary or digestive tract neoplastic focus was negative. DISCUSSION: E. coli cellulitis is a very uncommon usually fatal condition. Clinicians should be aware of a possible association with alcoholic cirrhosis. In case of recurrence, it is important to search for a digestive, hepatobiliary or urinary tract focus. Broad spectrum empirical antibiotic therapy must be initiated rapidly. Surgery is required in case of necrotizing cellulitis whatever the infectious agent.

Aged↗

[Etiologic problems posed by cervicofacial cellulitis].

A diffusing and lingering cellulitis is followed two months later by a right coxitis. Recovery of the coxitis and of the cellulitis is obtained by the antituberculous treatment. Authors demonstrate the possibility of the tuberculous etiology of the cellulitis.

Adult↗

Sinusitis as a cause of orbital cellulitis.

To determine the importance of sinusitis as a cause of orbital cellulitis, the causative organisms and peak age of occurrence, 25 patients hospitalized with orbital cellulitis (ages 8 months to 17 years; 80%, 1-4 years) were studied. Complete blood counts were carried out and radiographic sinus examinations and eye swabs (for culturing) performed prior to antibiotic treatment. Sinusitis was evident in 72% of the patients. Eye swab cultures indicated 80% had streptococcal, staphylococcal or enterococcal infection. The data indicate that sinusitis is an important cause of orbital cellulitis. The most common causative organisms were Streptococcus viridans (44%) and Staphylococcus aureus (32%). Initial antibiotics should therefore cover both organisms.

Adolescent↗

The effect of vitamin E on cellulitis in broiler chickens experiencing scratches in a challenge model.

Two experiments are described; each experiment contained five treatments with each treatment consisting of a specific diet and vitamin E at 8.82 mg, 41.89 mg, 74.96 mg, 108.03 mg, or 141.10 mg vitamin E per kilogram of feed. Birds were raised with continuous feed containing the various levels of vitamin E available throughout the experiment. At 4 wk of age, the birds were scratched on the breast and placed onto avian cellulitis Escherichia coli-seeded litter. One week later, the birds were euthanatized and lesion presence was noted. There appeared to be a positive correlation between vitamin E and the inhibition of cellulitis formation when the birds were fed a diet containing 74.96 mg vitamin E/kg feed. Conflicting results were seen in the two experiments when the birds were fed 41.89 and 108.03 mg vitamin E/kg feed. Both experiments had a high incidence of cellulitis in birds whose diets consisted of 141.10 mg vitamin E/kg feed.

Animals↗

Klebsiella pneumoniae orbital cellulitis.

We present a case of orbital cellulitis due to Klebsiellapneumoniae infection. The computed tomography revealed cellulitis over the right cheek with abscess formation in the right eyelid and ipsilateral chronic obstructive sinusitis. Incision and drainage of orbital abscess and functional endoscopic sinus surgery were performed sequentially. Klebsiella pneumoniae was confirmed via culture from these two lesions. The patient achieved complete remission without sequalae after surgical intervention and systemic antibiotics. We describe a successfully treated case of Klebsiella pneumoniae orbital cellulitis, which has never been reported before.

Cellulitis↗

[Painful bruising syndrome mimicking cellulitis of the leg].

BACKGROUND: Autoerythrocyte sensitization syndrome (painful bruising syndrome) is marked by spontaneous and painful ecchymotic bruising, without any biological abnormality, occurring in women with pathological mental profile. Sometimes, when the inflammation is severe, an infectious cellulitis or muscular compression may be suspected. CASE REPORT: A 21-year-old woman was referred for the rapid occurrence of a diffuse and painful inflammation of the right leg, with fever. The leg was red, warm, with diffuse bruising. The foot was fixed in varus equin. The biological parameters were normal. Magnetic resonance imaging showed normal muscles but modifications in the subcutaneous fat, similar to an acute cellulitis. A cutaneous biopsy showed a moderate oedema of the dermis and erythrocyte extravasation. Antibiotics were inefficient on the pain and the aspect of the lesions. Because of the efficacy of saline serum injections on the symptoms and a pathological psychological profile, an autoerythrocyte sensitization syndrome was suspected. The skin test was negative. Psychiatric evaluation revealed a severe personality disorder associated with depression. The ecchymotic lesions disappeared with adapted psychiatric treatment. DISCUSSION: Painful bruising syndrome occurs most often in young women with various psychiatric problems. The lesions are characterized by recurrent, painful, swollen and bleeding bruises in any part of the body. Fever, abdominal pain and external bleeding are possible. Haematological and immunological findings are usually normal. The histology of early lesions reveals oedema of the dermis and modest perivascular infiltrate, whereas extravasated erythrocytes appear later. The magnetic resonance imaging aspect of the lesions has never been described. Abnormalities of the subcutaneous fat are similar to those of acute cellulitis, expressing the inflammation process secondary to the ecchymoses. The syndrome results from complex somatic and psychological mechanisms. Many drugs were tried for the treatment of the disease, without any significant improvement.

Adult↗

Orbital cellulitis: a review of 21 cases from Ibadan, Nigeria.

This study was set up to review cases of orbital cellulitis admitted to the eye ward of our hospital between 1994 and 1998, and to compare the findings with similar studies. Twenty-one (14 males, 7 females, age range 45 days to 50 years [mean 13 years]) of 35 patients with an initial diagnosis of orbital cellulitis were reviewed (14 patients were excluded from the final analysis). Most of the cases were associated with pansinusitis, the commonest organism isolated being Staphylococcus aureus. All the patients were co-managed with ortorhinolaryngologists, and sometimes also with bacteriologists and paediatricians. Seventy-five per cent of the patients made a full recovery. Complications included orbital abscess (28.6%), optic atrophy (10%), cornea opacities (10%) and seizures (5%). Orbital cellulitis remains a childhood infection with potentially devastating consequences. There appears to have been a reduction not only in the number of cases admitted to the eye ward but also in the number and severity of complications. Prompt treatment and a multidisciplinary approach to management may be partly responsible for the improved outcome. This approach therefore needs to be encouraged.

Adolescent↗

[Haemophilus influenzae cellulitis of the hand: report of one case].

Cellulitis of extremities due to Haemophilus influenzae is rare in children. Only 60 cases of Haemophilus influenzae cellulitis of the extremities have been reported. It usually affects young children between the ages of six and 24 months. The lesion often presents with a red-to-bluish-purple discoloration overlying the involved area. High fever and leukocytosis are commonly found. Culture of needle aspirate and blood with appropriate media is necessary for diagnosis. Early diagnosis is especially important because of associated bacteremia and the subsequent possibility of life-threatening complications such as meningitis. We reported a 8-month-old female infant with Haemophilus influenzae type b cellulitis over the right hand. She was admitted due to high fever and painful swelling of the right hand. Edematous right hand with dusky erythematous skin over the dorsum and swelling of the palm with limitation of range of motion were noted on admission. Smear of needle aspirate revealed gram negative bacilli and beta-lactamase(-) Haemophilus influenzae type b was cultivated in the blood culture. She was successfully treated with ampicillin and discharged with stable condition.

Cellulitis↗

Orbital cellulitis and cavernous sinus thrombosis after cataract extraction and lens implantation.

Orbital cellulitis as a complication of ophthalmic surgery is uncommon. We treated a patient who had orbital cellulitis and cavernous sinus thrombosis three weeks after uncomplicated cataract extraction and lens implantation. Sinus x-rays showed sphenoid sinus opacification. Computed tomographic scan confirmed the sphenoid sinus disease, and no abscess was found. The patient recovered completely after treatment with intravenous antibiotics. Most orbital cellulitis is secondary to sinus disease. The trauma of surgery and the retrobulbar block must be considered possible causative factors in this patient, but sinus disease is still the most likely cause. Intraocular inflammation did not increase during the illness although the intraocular pressure rose from 14 to 23mmHg.

Cataract Extraction↗

[Brain abscess and diffuse cervico-facial cellulitis: complication after mandibular third molar extraction].

The authors report a case of cervico-facial cellulitis with brain abscess after mandibular third molar removal. This is the observation of a 26 years old boy surgically treated for a cervico-facial cellulitis ten days after a third molar's removal. He was given anti-inflammatory drugs after removal for analgesia. After a phase of clinical improving, the patient developed pulmonary and brain abscess with neurological signs. He needed neurosurgery in emergency. After eight weeks of antibiotic treatment, the patient was cured with aftereffects (jaw constriction and sensory disorders of the right thigh). Cerebro-meningeal complications of diffuse cervico-facial cellulitis are exceptional but are responsible for heavy aftereffects. This observation confirms that using anti-inflammatory drugs for analgesia is associated with a higher rate of complications after dental removal.

Adult↗

Aeromonas hydrophila orbital cellulitis in a patient with myelodysplastic syndrome.

Orbital cellulitis caused by Aeromonas hydrophila developed in a 73-year-old male with a history of myelodysplastic syndrome. He was admitted because of fever, general malaise, pain as well as periorbital swelling in the right eye. Four days later, a yellowish pustule with purulent material was noted over right lower eyelid. Aeromonas hydrophila was isolated from the discharge. After administering intravenous cefuroxime 1,500 mg every 8 hours and topical ofloxacin eye oint, his symptoms subsided gradually. We present the first known case of orbital cellulitis from Aeromonas hydrophila in a patient with myelodysplastic syndrome. In patients with myelodysplastic syndrome, Aeromonas hydrophila should be listed as an important pathogen in any soft tissue infection including eyelid infection. Culture and adequate antimicrobial therapy are recommended, because rapid worsening may result in orbital cellulitis or even septicemia in patients with suppressed immune system.

Aeromonas hydrophila↗

[Sweet syndrome presenting as orbital cellulitis].

BACKGROUND: A case of Sweet syndrome mimicking orbital cellulitis is reported. CASE: A 17-year-old girl presented with painful eyelid swelling, limited ocular movement in the right eye, and an increased white cell count. The patient was initially diagnosed as having infectious orbital cellulitis, but her symptoms did not improve with administration of intravenous carbanpenem and cefzon. Systemic examination revealed erythema of the extremities, and blood tests showed elevated C-reactive protein. These findings are consistent with a diagnosis of Sweet syndrome, and the patient was treated with 30 mg of oral prednisone. The eyelid swelling and erythema of the extremities decreased one day after the initiation of corticosteroid therapy. Skin biopsy showed infiltration of neutrophils and histiocytes in the dermis, confirming the diagnosis of Sweet syndrome. CONCLUSION: Sweet syndrome with eyelid and orbital involvement may mimic infectious orbital cellulitis.

Adolescent↗