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PubMed1987

Cellulitis of the penis and scrotum due to group B streptococcus.

Group B streptococcus was isolated from the blood, penile exudate and needle aspirate of cellulitis in a severely ill neonate with a rapidly progressive infection of the scrotum, penis and lower abdominal wall. This case demonstrates the need to evaluate and to manage newborns with scrotal cellulitis differently than older children and adults. A different group of organisms and a greater likelihood for systemic involvement are to be anticipated in newborns.

Cellulitis↗
PubMedDate not supplied

Group B streptococcal toxic shock-like syndrome with fulminant cellulitis.

Nonperipartum group B streptococcus infection usually occurs in elderly persons and in patients with underlying systemic diseases (e.g., diabetes, malignancy, or alcoholism). Group B streptococcal infections in adults are often life threatening, and have been associated with a toxic shock-like syndrome. We present a case of fulminant group B streptococcal cellulitis in a patient with sarcoidosis who was receiving corticosteroid therapy and who became hypotensive as her cellulitis rapidly progressed to involve her entire right thigh.

Anti-Bacterial Agents↗
PubMed1995

Streptococcal preseptal cellulitis complicated by the toxic Streptococcus syndrome.

BACKGROUND: After decades of decline in the incidence of severe infections secondary to group A streptococci, a dramatic increase in the frequency and severity of infections with these organisms has been reported since 1984, including a "toxic Streptococcus syndrome," resembling staphylococcal toxic shock syndrome. To the authors' knowledge, this entity has never been described after ocular infection. METHODS: In a previously healthy 3-year-old boy, preseptal cellulitis developed secondary to minor trauma to the eyelid, progressing rapidly to hypotension, respiratory distress, and an erythrodermic desquamating rash. Ocular and blood cultures grew group A beta-hemolytic streptococci. Appropriate antibiotic coverage and management of systemic manifestations led to rapid improvement, although necrosis developed in the right upper anterior eyelid, requiring skin grafts. RESULTS: More than 3 years since the incident, the patient is free of infection and has a good cosmetic result after skin grafting and revisions for scarring and adhesions. CONCLUSIONS: Streptococcal preseptal cellulitis is not unusual, particularly after trauma. Ophthalmologists must be aware of the re-emergence of more virulent organisms with increased potential for morbidity and mortality.

Anti-Bacterial Agents↗
PubMed1998

Unilateral Blastomyces dermatitidis endophthalmitis and orbital cellulitis. A case report and literature review.

PURPOSE: The authors report the clinical, cytologic, and histopathologic findings of a unique presentation of concomitant unilateral endophthalmitis and orbital cellulitis secondary to Blastomyces dermatitidis. DESIGN: Case report. METHODS: A 29-year-old healthy woman with a history of pulmonary tuberculosis presented with a painful right eye and rapidly decreasing vision. Fundus examination showed a diffuse elevated choroidal lesion at the posterior pole. With an otherwise unremarkable systemic work-up, the patient was treated with systemic antibiotics and corticosteroids for a presumed diagnosis of choroidal tuberculous granuloma. After an initial response to the treatment, the patient's condition deteriorated rapidly with visual acuity decreasing from 20/25 to no light perception in 3 months. Ipsilateral proptosis developed with magnetic resonance imaging showing a poorly defined orbital mass. Surgical enucleation and an orbital biopsy were performed. RESULTS: Histopathologic examination of the orbital specimen and an intact enucleated globe showed a diffuse necrotizing granulomatous process with the presence of numerous yeasts consistent with B. dermatitidis. This subsequently was confirmed by positive culture of B. dermatitidis from the orbital specimen. CONCLUSIONS: This is a unique case of concurrent unilateral endophthalmitis and orbital cellulitis secondary to B. dermatitidis. Intraocular dissemination of blastomycosis should be suspected in the differential diagnosis of endophthalmitis in patients with previous or active pulmonary lesions of equivocal nature. Early diagnosis and prompt treatment with antifungal medications are essential.

Adult↗
PubMed1983

Cellulitis in children caused by Haemophilus influenzae type b.

Of 31 episodes of invasive infection by Haemophilus influenzae capsular type b, occurring in children during a 26-month period, five (16 per cent) had cellulitis as the presenting feature. In four of the five patients bacteraemia was detected. This frequency of presentation is not reflected in reports in the British literature. Prompt recognition of this aetiology of cellulitis is important for effective chemotherapy.

Cellulitis↗
PubMed2003

Eosinophilic cellulitis as a cutaneous manifestation of idiopathic hypereosinophilic syndrome.

Three patients with eosinophilic cellulitis associated with sustained peripheral blood eosinophilia of unidentified cause are reported. They also presented with diversities of extracutaneous symptoms such as bronchospasm, sensory polyneuropathies, epigastralgia, and gangrenous eosinophilic enteritis. These cases suggest that eosinophilic cellulitis can develop as a cutaneous manifestation of idiopathic hypereosinophilic syndrome.

Adult↗
PubMed1989

Eosinophilic cellulitis and eosinophilic pustular folliculitis.

This report describes a patient with a drug reaction and histologic changes of both eosinophilic cellulitis and eosinophilic pustular folliculitis. We propose that some cases of eosinophilic pustular folliculitis, like eosinophilic cellulitis, may occur as a result of a hypersensitivity phenomenon.

Cellulitis↗
PubMed1981

Hemophilus influenzae cellulitis of the hand.

Hemophilus influenzae type b cellulitis of the hand is a rare infection presenting mainly in the 2-month to 3-year age group. Three proven cases and one clinical case are reported, and the bacteriology and management are discussed. Most of these infections respond to ampicillin and/or chloramphenicol. One must include H. influenzae type b in the differential diagnosis of cellulitis of the hand in this age group and specify this possibility on all cultures so that appropriate identification of the organism can be made.

Ampicillin↗
PubMed1998

[Four hours for a record, or a severe fuminating cellulitis: can Saccharomyces cerevisiae be the causal agent?].

A 31-year-old woman presented with a subcutaneous cellulitis which occurred within four hours following a minor wound of a knee. This very short delay could be explained neither by the health state, nor the mechanism of injury, nor the bacteria usually responsible for such a cellulitis. Considering the clinical characteristics (high gas production) and the professional context (wine cellar employee), Saccharomyces cerevisiae, a yeast used for wine or bread production, may explain this complication.

Adult↗
PubMedDate not supplied

Intraoral and transcutaneous cervical ultrasound in the differential diagnosis of peritonsillar cellulitis and abscesses.

AIMS: The objective of the present study was to determine the specificity, sensitivity and accuracy of intraoral and transcutaneous ultrasound (US) in the diagnosis of peritonsillar cellulitis and abscess. STUDY DESIGN: Clinical-Prospective. MATERIAL AND METHODS: Thirty nine patients were seen at the otorhinolaryngology emergency department of the University Hospital, of the School of Medicine, University of São Paulo, with a clinical diagnosis of peritonsillar cellulitis or abscess. After initial evaluation, all patients were submitted to intraoral and transcutaneous US. RESULTS: Intraoral US was performed on 35 cases and its sensitivity was of 95.2%, the specificity was of 78.5% and the accuracy was of 86.9%. Transcutaneous US was feasible in all 39 patients and diagnosed peritonsillar abscess in 53.8%. There were 5 false-negatives and 1 false-positive result, sensitivity was 80%, specificity was 92.8% and accuracy was 84.5%. CONCLUSION: Intraoral US was quite sensitive in the diagnosis of peritonsillar abscesses when performed by an experienced radiologist. Specificity was higher for transcutaneous US compared to intraoral US. However, when transcutaneous US was performed in patients with trismus, it was able to diagnose all peritonsillar abscesses, since they were large collections which are common in patients with trismus. These exams showed similar accuracy.

Adolescent↗
PubMed1996

Synergistic necrotizing cellulitis resulting from peri-tonsillar abscess.

This case demonstrates the rare but potentially fatal condition of synergistic necrotizing cellulitis of the head and neck. Although similar to necrotizing fasciitis, this is more extreme as it also destroys muscle. Peri-tonsillar abscess is a recognized cause, but has not previously been described in this country, however it is a condition commonly referred to otolaryngologists and awareness of the complication of synergistic necrotizing cellulitis is necessary to allow early recognition and prompt treatment. This should be by broad-spectrum intravenous antibiotics with extensive surgical debridement and drainage procedures repeated as necessary. Although this case had a successful outcome, many patients do not survive, particularly if treatment is delayed or inadequate.

Cellulitis↗
PubMed1996

Squamous cell carcinoma of the pharynx and larynx presenting as a neck abscess or cellulitis.

Head and neck tumours presenting as a neck abscess or cellulitis are extremely rare. We report two cases of supraglottic squamous cell carcinoma which presented as an abscess in the site of metastatic neck nodes, one of which was occult and a third case of squamous cell carcinoma of the pyriform fossa which presented as cervical cellulitis. Biopsy of the abscess wall at the time of drainage and careful follow-up may lead to an earlier diagnosis of occult carcinoma.

Abscess↗
PubMed2002

Epidemiology and microbiology of cellulitis and bacterial soft tissue infection during HIV disease: a 10-year survey.

BACKGROUND: Cellulitis and soft tissue infection are underestimated complications of HIV disease. PATIENTS AND METHODS: Sixty-seven bacteriologically proven consecutive episodes were identified among 2221 HIV-infected patients hospitalized in a 10-year period, and assessed according to several epidemiological, microbiological and clinical variables. RESULTS: Staphylococcus aureus was the most frequently cultured pathogen (50% of 92 isolates), followed by Pseudomonas spp., Escherichia coli and Streptococcus pyogenes; a polymicrobial infection was present in 38.1% of episodes. Drug addiction (p < 0.003) and male gender (p < 0.04) were significantly associated with the occurrence of these complications, which were community-acquired in 83.6% of cases. While a remarkable variation in the severity of underlying immunodeficiency was shown, hematogenous dissemination occurred in 25.4% of episodes, and proved significantly related to a low CD4+ lymphocyte count, and neutropenia. A 21.7% methicillin-resistance rate was shown among S. aureus isolates. All episodes were favorably treated in 5-16 days, in over 60% of cases with associated beta-lactam-aminglycoside antibiotics; a recurrence of staphylococcal cellulitis occurred in four patients only. CONCLUSION: Skin and soft tissue infections are continuing causes of morbidity in HIV-infected patients, even in the highly active antiretroviral therapy era.

AIDS-Related Opportunistic Infections↗
PubMed2000

Tuberculous cellulitis.

We report a case of cutaneous tuberculosis presenting as cellulitis. The patient was a 63-year-old Korean woman who also had diabetes mellitus and a 20-year-history of oral corticosteroid medication prescribed for arthralgia. In addition, she had had pulmonary tuberculosis 20-year previously for which she received systemic treatment for 1 year. Her clinical cellulitis failed to respond to antibiotic therapy. Subsequent investigations, using histopathology and polymerase chain reaction, established an alternative diagnosis of cutaneous tuberculosis. The skin eruption cleared after treatment with isoniazid, rifampicin, ethambutol and pyrazinamide. This case represents a most unusual presentation of tuberculosis in the skin. The atypical features may reflect the patient's general medical state.

Antitubercular Agents↗
PubMedDate not supplied

Synergistic necrotizing cellulitis as a complication of peritonsillar abscess.

Peritonsillar abscess, a complication of tonsillitis, is not uncommon. The usual treatment consists of needle aspiration or surgical drainage and antibiotic treatment. Tonsillectomy may be used in the management of this condition, either at the time of diagnosis or after an interval period. Severe complications of peritonsillar abscess are rare. Synergistic necrotizing cellulitis is a fulminant infection associated with spread along fascial plains, necrosis of connective tissue and muscle, and high mortality. It is usually otondogenic in origin in the cervicofacial area and occurs in debilitated or immune compromised patients. We discuss cervicofacial-necrotizing soft tissue disease and report an unusual case of extensive synergistic necrotizing cellulitis of the neck, chest, and shoulder as a result of a peritonsillar abscess.

Cellulitis↗
PubMed2001

Sweet's syndrome in acute myelogenous leukemia presenting as periorbital cellulitis with an infiltrate of leukemic cells.

Sweet's syndrome is characterized by the abrupt onset of fever, neutrophilic leukocytosis, and erythematous, tender pseudovesiculated plaques or nodules that respond readily to corticosteroid therapy. It is usually distinguished by the presence of mature neutrophils on histopathologic examination. We describe a 38-year-old man with acute myelogenous leukemia who had an erythematous vesicular eruption of the left eye develop that resembled cellulitis. A biopsy specimen revealed a dermal infiltrate of mature neutrophils and immature myeloblastic precursors. He later had hemorrhagic pseudovesiculated plaques develop bilaterally on his hands. A biopsy specimen again revealed abundant neutrophils with immature forms. A similar eruption developed at the site of a Hickman catheter placement 4 months later. His skin lesions responded rapidly to oral corticosteroids. This case is unique in that his initial presentation of Sweet's syndrome resembled orbital cellulitis that was characterized by immature myeloid precursors on histopathology.

Administration, Oral↗
PubMed2003

Postoperative pneumococcal cellulitis in systemic lupus erythematosus.

This paper reports a case of nosocomial pneumococcal cellulitis that developed following a lymph-node biopsy in a woman being treated with high-dose intravenous corticosteroids for systemic lupus erythematosis (SLE). Her rapid and severe clinical deterioration was similar to that caused by group A streptococcus. The risk factors for the development of nosocomial pneumococcal cellulitis as a complication of SLE are reviewed and preventive measures discussed.

Adult↗
PubMed2004

Retinoblastoma presenting as orbital cellulitis: report of four cases with a review of the literature.

PURPOSE: To analyze the clinical and histopathological features of retinoblastoma presenting as orbital cellulitis. MATERIAL AND METHODS: Retrospective analysis of case records and review of the histopathology of four patients with retinoblastoma presenting as orbital cellulitis.RES U LTS On histopathological examination, all eyes showed anterior segment involvement with extensive necrosis. One case had a well-differentiated tumor and one showed extraocular extension of the tumor. CONCLUSION: Advanced necrotic retinoblastoma with anterior segment involvement may often present as orbital cellulitis.

Anterior Eye Segment↗