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PubMedDate not supplied

Ampicillin-resistant H influenzae cellulitis and shock in an adult.

Over a three-day period, pharyngitis, neck swelling, deep voice, dysphagia, fever, and cellulitis of the anterior neck and upper chest developed in a 63-year-old woman. Sixteen hours following the institution of intravenous ampicillin, septic shock developed and the patient became comatose. Ampicillin-resistant Hemophilus influenzae type B was found in a culture taken from her blood and pharynx. In patients who have an upper respiratory tract infection and severe cellulitis of the neck, initial therapy should include chloramphenicol because of the possibility of ampicillin-resistant Hemophilus influenzae infection.

Ampicillin↗
PubMed1989

Clinicopathologic characterization of canine juvenile cellulitis.

The syndrome of canine juvenile cellulitis was observed and characterized throughout its clinical course when it occurred spontaneously in a litter of dogs. Histologically, pyogranulomatous inflammation was seen in facial skin and mandibular and superficial cervical lymph nodes of affected dogs. The predominant inflammatory cell characterized by light and electron microscopy and by immunohistochemical staining was an epithelioid macrophage. The same pyogranulomatous inflammatory process was seen in a lymph node anatomically distant from the site of apparent disease. Interestingly, a littermate with neither clinically evident dermal lesions nor lymphadenopathy had histologic evidence of a milder, but similar inflammatory process in a mandibular lymph node. The observation of canine juvenile cellulitis in clusters of dogs between 1 and 4 months of age and its apparent systemic nature suggest an infectious etiology. Bacterial, fungal, or viral agents were not isolated from affected lymph nodes. Attempts to transfer the disease by inoculation of neonatal puppies with tissue from affected dogs were also unsuccessful.

Animals↗
PubMed1982

Evaluation of orbital cellulitis and results of treatment.

Optimal management of patients with orbital cellulitis depends on how accurately the disease is classified and on the appropriateness with which antibiotics and surgery are used to treat the disease. Therapy must be adjusted on the basis of the extent of the disease. In order to determine the balance of treatment modalities which is most beneficial for certain disease presentations, we reviewed a series of 303 patients with orbital cellulitis. The anatomical and bacteriological etiology of the disease was determined in each case on the basis of the examination, visual acuity, results of sinus radiography, results of culture, ultrasonography, and computerized tomography. To avoid the 5% complication rate that occurred in this series, an evaluation and treatment protocol is recommended.

Abscess↗
PubMedDate not supplied

Preventing cellulitis in older people with persistent lower limb oedema.

Persistent lower limb oedema is an underestimated problem in the elderly population. Oedematous tissue predisposes the individual to the development of bacterial infections. Accurate assessment of the underlying aetiology and application of compression hosiery could prevent cellulitis and reduce the risk of recurrent episodes. Awareness of the complications of leg oedema needs to be raised in the general population. Healthcare professions require education to enable the provision of safe, effective treatment to reduce morbidity relating to chronic oedema and cellulitis. The 'National Service Framework for Older People' and the 'British Lymphology Society's Framework for Education' could facilitate the development of national service provision to meet the needs of the population with chronic oedema.

Aged↗
PubMed2005

Bullous "cellulitis" with eosinophilia: case report and review of Wells' syndrome in childhood.

A 1-year-old girl presented with acute onset of edematous erythematous plaques associated with bullae on her extremities and accompanied by peripheral eosinophilia. She was afebrile, and the skin lesions were pruritic but not tender. The patient was treated with intravenously administered antibiotics for presumed cellulitis, without improvement. However, the lesions responded rapidly to systemic steroid therapy. On the basis of lesional morphologic features, peripheral eosinophilia, and cutaneous histopathologic features, a diagnosis of Wells' syndrome was made. Wells' syndrome is extremely rare in childhood, with 27 pediatric cases reported in the literature. Because it is seen so infrequently, there are no specific guidelines for evaluation and management of Wells' syndrome among children. The diagnosis should be considered for children with presumed cellulitis and eosinophilia who fail to respond to antibiotics. Evaluation should include a directed history, physical examination, complete blood count, and stool testing for ova and parasites, to identify potential triggers. Treatment is with systemic steroid therapy unless disease is limited, in which case medium/high-potency topical steroids may be indicated. If systemic features are prominent or disease is chronic (lasting >6 months), then a referral to hematology/oncology should be considered.

Cellulitis↗
PubMed2000

Increased therapeutic failure for cephalexin versus comparator antibiotics in the treatment of uncomplicated outpatient cellulitis.

We reviewed records of outpatients to determine the therapeutic failure rate of cephalexin in treating uncomplicated cellulitis. Therapeutic failure was defined as an increase in antibiotic dosage, prescription renewal, or addition or substitution of another antibiotic. Demographics, physical characteristics, risk factors, intervention, and outcome data were collected. Twenty-seven percent of patients failed therapy with an oral antibiotic. The failure rate for cephalexin was 40% versus 20% for comparator antibiotics (p=0.02, odds ratio [OR] 2.62, 95% confidence interval [CI] 1.18-5.75). We identified no statistically significant variables related to cephalexin failure. Concomitant acid suppressive therapy was administered with cephalexin in 42% of failures and 20% of nonfailures (p=0.11, OR 2.78, 95% CI 0.77-9.87). These data suggest that cephalexin's efficacy was less than that of other antimicrobials in treating cellulitis, possibly related to concurrent acid suppression.

Anti-Bacterial Agents↗
PubMed2001

Unilateral proptosis and orbital cellulitis in eight African hedgehogs (Atelerix albiventris).

Eight African hedgehogs (Atelerix albiventris) were presented with unilateral proptosis. Six animals presented specifically for an ocular problem, whereas two had concurrent neurologic disease. Enucleation and light microscopic examination of tissues was performed in five animals, and euthanasia followed by complete postmortem examination was performed in three animals. Histopathologic findings in all hedgehogs included orbital cellulitis, panophthalmitis, and corneal ulceration, with perforation in seven of eight eyes. The etiology of the orbital cellulitis was not determined, but it appeared to precede proptosis. Orbits in hedgehogs are shallow and the palpebral fissures are large, which may predispose them to proptosis, similar to brachycephalic dogs. This clinical presentation was seen in 15% (8/54) of African hedgehogs presented to the Western College of Veterinary Medicine over a 2-yr period from January 1995 to December 1996 and warrants further investigation.

Animals↗
PubMed1996

Immune response to anaerobic bacteria in patients with peritonsillar cellulitis and abscess.

The role of four oral organisms (Fusobacterium nucleatum. Prevotella intermedia, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans) was investigated in 19 children with peritonsillar abscess, and 17 with peritonsillar cellulitis. Antibody titers to these organisms were measured by enzyme- linked immunosorbent assay in the patient, as well as in 32 control patients. Serum levels in the patients were determined at day 1 and 42-56 days later. Significantly higher antibody levels to F. nucleatum and P. intermedia were found in the second serum sample of patients with peritonsillar cellulitis or abscess, as compared to their first sample or the levels of antibodies in controls. A total of 136 bacterial isolates, 100 anaerobic and 36 aerobic were isolated from the 19 peritonsillar abscesses. Anaerobic bacteria were found in all abscesses, and they were mixed with aerobic bacteria in 5 (26%). F. nucleatum was recovered in 14 (74%) abscesses and P. intermedia was isolated in 13 (68%). The elevated antibody levels to F. nucleatum and P. intermedia, known oral pathogens, suggest a pathogenic role for these organisms in peritonsillar infections.

Abscess↗
PubMed1994

Cellulitis as first clinical presentation of disseminated cryptococcosis in renal transplant recipients.

Two renal transplant recipients with cellulitis due to Cryptococcus neoformans are described. The patients were treated empirically for a presumed bacterial erysipelas, but without response. Examination of skin biopsies revealed C. neoformans as the causative organism. In both patients the cellulitis was the presenting clinical manifestation of disseminated cryptococcosis. Therapy with antifungal agents was successful. Disseminated cryptococcal disease occurs mainly in immunocompromised patients. When left untreated, it nearly always has a fatal course. Early diagnosis and appropriate therapy are therefore essential.

Adult↗
PubMed1995

Atypical cellulitis due to group B streptococcus.

In a minority of late-onset Group B streptococcal (GBS) cases in neonates, facial or buccal cellulitis has been described. We report a case of sepsis with GBS, in which an atypical cellulitis in the inguinal area was seen as presenting symptom.

Amoxicillin↗
PubMed1997

Cellulitis associated with an oral source of infection in breast cancer patients: report of two cases.

We present 2 patients with prior lumpectomy, axillary node dissection and radiation therapy for treatment of breast cancer, who subsequently developed arm and chest cellulitis associated with an oral infection (gingivitis with bacteremia in one patient, and dental abscess in another). Our findings suggest that hematogeneous seeding of the compromised extremity and/or breast from the oral cavity should be considered as a possible cause of cellulitis in breast cancer patients.

Aged↗
PubMedDate not supplied

Unusual case of acute orbital cellulitis.

A three and one-half year-old female who presented with orbital cellulitis and leukocoria is described. Enucleation was performed as the eye was microophthalmic, blind, and painful. Histopathologic study revealed uveitis with total retinal detachment. The etiology of the retinal detachment was indeterminable. The differential diagnosis of orbital cellulitis in children is reviewed.

Cellulitis↗
PubMedDate not supplied

Periorbital cellulitis in infancy.

To our knowledge, no previous study of periorbital cellulitis has focused on its specific characteristics in infants only (less than 1 year of age.) We retrospectively studied 30 cases of infantile periorbital cellulitis treated at Harbor-UCLA Medical Center from 1977 to 1988. Characteristics of the disorder in our infants older than 1 month were similar to earlier reports of older children in terms of etiology, radiological and bacteriological findings, and course. However, compared with our older infants, our seven neonates (7 to 30 days old) had a higher incidence of ruptured dacryocele (29% vs 0%) and unknown source of the infection (43% vs 4%); but a lower incidence of preceding upper respiratory infection (14% vs 78%), abnormal sinus films (0% vs 22%), and positive blood cultures (14% vs 30%). Of the positive cultures, Hemophilus sp was the most common pathogen among the older infants (35%), while Streptococcus and Staphylococcus were the most frequent among the neonates (71%). All infections remained preseptal and responded well to intravenous antibiotics.

Cellulitis↗
PubMedDate not supplied

An unusual case of cellulitis associated with a Molteno implant in a 1-year-old child.

The Molteno seton implant has recently been used in pediatric patients with advanced childhood glaucoma, who would otherwise have been treated with cyclodestructive surgery. We report a case of Molteno implant (first stage) associated with orbital cellulitis in a 1-year-old child. The presence of the implant was initially unrecognized until, in the course of evaluation for orbital cellulitis, computerized tomography of the orbit suggested a foreign body. We believe this is the first report of a complication associated with the first stage of this procedure.

Cellulitis↗
PubMedDate not supplied

Clinical practice guidelines for the management of orbital cellulitis.

PURPOSE: A retrospective study was performed to review the management of periorbital and orbital cellulitis at Miami Children's Hospital, between January 1, 1993 and February 15, 1996. RESULTS: One hundred and one patients were included in this study. The variables analyzed in this study included age, sex, length of hospital stay, imaging studies, laboratory tests, and microbiology specimens collected. Patients were classified according to the modified Chandler classification. Average length of stay for our patient population was 4.5 days. Data regarding the radiologic studies, laboratory tests, and microbiology yield of specimens were analyzed. CONCLUSIONS: The incidence of orbital infection, manifested by lid swelling alone is much more common (stages I and II) than orbital infection involving postseptal findings (stages III, IV, and V); 84.16% compared with 15.84%, respectively. An updated approach and a general guideline for the management of periorbital and orbital cellulitis according to the clinical staging of the process is presented.

Anti-Bacterial Agents↗
PubMed2004

Gram-negative cellulitis complicating cirrhosis.

Gram-negative infections are common in patients with cirrhosis, but skin infections are usually caused by gram-positive cocci. Gram-negative bacteria should be considered as a potential etiologic agent in patients with cirrhosis and severe bullous cellulitis. Culture of the bullous fluid may facilitate diagnosis and management. Early recognition is important because the course of the disease is usually rapid and fatal. We report 4 cases of fulminant gram-negative bullous cellulitis and septic shock in patients with cirrhosis.

Adult↗
PubMedDate not supplied

A dermatosis resembling juvenile cellulitis in an adult dog.

A two-year-old, female Lhasa apso presented with an acute onset of fever, anorexia, lethargy, prescapular and mandibular lymphadenopathy, otitis externa, and a dermatitis involving the perioral and auricular skin. Histopathological examination of affected skin and a mandibular lymph node was diagnostic for juvenile cellulitis. Extensive hematological, serological, urine, skin, and fecal testing together with special staining, immunofluorescence, and electron microscopic examination of skin and lymph node biopsies failed to reveal an underlying etiology. After 15 weeks the condition resolved completely. This represents the first adult case of a dermatosis fitting the clinical, histological, and clinicopathological description ascribed to juvenile cellulitis.

Animals↗