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PubMed1992

[Leg cellulitis caused by Aeromonas hydrophila. Medical treatment].

A case of cellulitis of the leg caused by Aeromonas hydrophila in a cirrhotic patient is reported. The starting point of the infection could not be determined with certainty, but a direct local inoculation during foot-baths was suspected. Because of clinical signs suggestive of erysipelas, the disease was initially treated without success with penicillin G, which raises questions concerning the choice of the initial antibiotic therapy for cellulitis of the leg in immunocompromised patients, pending the bacteriological results. A purely medical treatment (adequate antibiotic therapy) resulted in complete cure of this patient, despite the fact that his lesions were necrotizing.

Aeromonas hydrophila↗
PubMedDate not supplied

Postoperative cellulitis of the foot and lower leg following coronary bypass.

Greater saphenous vein grafts are standardly used for coronary artery bypass grafting. Recurrent acute cellulitis of the saphenous vein-donor extremity is an infrequently reported complication. The authors present a protocol designed to reduce the incidence of the recurrent cellulitis through proper preoperative assessment and postoperative management.

Cellulitis↗
PubMed2004

Maxillofacial cellulitis.

Of all infections associated to oral pathology, the most relevant ones are those that are related to dental pathology. Cellulitis is an infection of the cellular adipose tissue located in the aponeurotic spaces. It can be classified on the basis of location, severity and evolution. The aponeurotic compartments that allow odontogenic infections to spread have been categorised as: superficial compartment, floor of the mouth, masticator compartment, parapharyngeal space, parotid space and paratonsillar space. The present work describes the anatomical structures that comprise these spaces. The clinical forms of facial cellulitis are divided into acute and chronic. Potential complications consist of orbital infections, necrotising fascitis, thrombosis of the cavernous sinus, cerebral abscess and mediastinitis. Diagnosis is made on the basis of anamnesis, physical examination and complementary procedures (analytical tests and imaging studies). Treatment includes: treatment of causes (depending on the underlying cause in each case), incision and drainage, antibiotic therapy (chosen empirically) and complementary medical care. Odontogenic infections are primarily treated with surgery and coadjuvant antibiotic therapy.

Anti-Bacterial Agents↗
PubMed2004

[A case of eosinophilic cellulitis (Wells' syndrome)].

A 67-year-old man sustained a minor injury on the right hand after touching a potted plant. Several days later, he noted erythema and marked swelling on the right hand and forearm. The same lesions developed on the left hand and forearm. He also had pruritic erythema on the neck, trunk, and thighs. The initial clinical diagnosis was bacterial cellulitis and contact dermatitis. However, oral antibiotic and topical steroid therapy were not effective. Laboratory investigations revealed peripheral blood eosinophilia, elevated serum IgE level, and positive antinuclear antibody. Histopathological examination of a skin biopsy specimen showed an excessive infiltration of eosinophils and flame figures in the dermis. We diagnosed this case as eosinophilic cellulitis (Wells' syndrome). The skin lesions responded rapidly to the systemic oral steroid therapy. There has been no recurrence of eruption in 1 year of follow-up. The condition of the disease was correlated to peripheral blood eosinophil counts, and serum eosinophil cationic protein levels. However, serum interleukin-5 levels were within normal limits.

Aged↗
PubMedDate not supplied

Prolonged cellulitis due to plant thorn.

We report the case of a five-year-old healthy boy who was admitted with abscess and soft tissue infection between the left wrist and the distal end of the forearm. Postero-anterior X-ray examination of the forearm showed a transverse line on the radius; however, further comparative radiographic examinations of the forearm were not compatible with fracture. Enterobacter cloacae was identified in the pus culture and initial intravenous empiric treatment with sulbactam-ampicillin was continued. Although the microorganism was susceptible to the empiric antimicrobial agent, at the eighth day of the treatment, inflammatory drainage was still present so further evaluations were performed. Ultrasonography of the forearm and wrist revealed only collection; magnetic resonance imaging showed a foreign body on the anterior distal section of the left forearm. The patient underwent operation and a 22 mm wooden foreign body was removed. Detailed history after removing a tree branch particle revealed that the boy had recently fallen from a tree causing an abrasion over the left wrist. The postoperative course was uneventful and clinical response was excellent in two days. In view of this case report, we would like to emphasize the importance of medical history and imaging studies in cases of cellulitis that do not respond to appropriate antimicrobial therapy. Another point to be kept in mind is that Enterobacter cloacae, which is very rarely reported as a causative agent for cellulitis, could be the etiological agent in cases after plant thorn injuries.

Cellulitis↗
PubMed2006

[Postseptal orbital cellulitis and sinusitis. Descriptive study of 8 cases and literature review].

This is a retrospective study of 8 patients with postseptal orbital cellulitis (stages II-V of Chandler) caused by sinusitis during 1999-2003. The variables analyzed in this study included age, sex, delay in diagnosis, aetiology, imaging studies, microbiology specimens collected and treatment. Delays in diagnosis were frecuent. CT was the best radiologic study. Polymicrobial infections were the rule, including anaerobes. 4 patients of 8 needed surgical drainage. A general guideline for the management of periorbital and orbital cellulitis according to the clinical staging of the process is presented.

Adolescent↗
PubMed2006

Ultrasound treatment of cellulitis in the maxillofacial region: a ten-year experience.

AIM: To evaluate the effect of therapeutic ultrasound in the treatment of cellulitis in the maxillofacial region. PATIENTS AND METHODS: We report our experience in the management of maxillofacial cellulitis in thirty six patients using therapeutic ultrasound as an adjunct to the standard treatment. The patients were allocated to two groups: group A, treated by surgery, drugs and ultrasound therapy, and group B, where the patients were treated only surgically and medicamentously. The effect of treatment was evaluated on the basis of inflamed tissue volume reduction and normalization of tissue structure determined by ultrasonography. RESULTS: The dynamic changes in the mean values of inflamed tissue volume indicated more rapid reduction in group A in which therapeutic ultrasound was applied. Analysis of the ultrasonographic images in group A demonstrated merging of the miliary liquid foci as early as the first day of treatment. They coalesced, and this coincided with the initiation of purulent discharge. The reduction in volume was due to the accelerated elimination of breakdown inflammatory products from the tissues. CONCLUSION: The better results in group A compared with group B suggest that the method for ultrasound management was effective and could be recommended for use in clinical practice.

Cellulitis↗
PubMed2006

A case of cellulitis that complicated lymphedema of the lower limb and produced systemic inflammatory response syndrome (SIRS).

This is the first report describing lymphedema of the lower limb after surgery for ovarian cancer complicated by severe cellulitis with systemic inflammatory response syndrome (SIRS). Debridement of the lesion and a split-thickness graft were required for a complete cure. Although lymphedema as a complication after surgery for gynecologic malignancies is prone to be considered less serious on the medical side, it is considered necessary to treat lymphedema of the lower limbs while it is still in a mild state since severe cellulitis may accompany lymphedema, as in the present case.

Cellulitis↗
PubMed1991

Cutaneous cellulitis.

Cellulitis has long been postulated to be the result of antecedent bacterial invasion with subsequent bacterial proliferation. Nonetheless, the difficulty in isolating putative pathogens from cellulitic skin has served to cast doubt on this hypothesis. In this regard, the skin is provided with a unique set of lymphoid and reticular cells with the capacity to secrete lymphokines and cytokines. These substances rapidly reduce the number of viable bacteria from infection by enhancing the infiltration of skin by circulating macrophages and neutrophils. The warmth and erythema associated with cellulitis are most likely produced both by a small number of residual bacteria and by fragmented bacterial remnants, and amplified by the lymphokines that are secreted in response to antigenic challenge. Anti-inflammatory agents may play a significant role in enhancing the resolution of infection by reducing the production of soluble mediators by these intra-epidermal immunocompetent cells.

Bacteria↗
PubMed1990

[Eosinophilic cellulitis (Wells' syndrome)].

The Authors report a case of eosinophilic cellulitis (Wells' syndrome). The patient was a 61 year old woman, diabetic, with a cardio-respiratory insufficiency and a maniaco-depressive psycosis. She presented, on the upper arms and trunk, a cutaneous eruption of erythematous-urticarial plaques, that histopathologically were characterized by a dermic leukocyte population, with a prevalence of eosinophils, distributed in the perivascular site. Laboratory tests revealed eosinophilia and circulating immune complexes. The etiopathogenesis of the disease is discussed as is the possible role of immune complexes in eosinophilic cellulitis.

Cellulitis↗
PubMedDate not supplied

[Crepitant abdominal cellulitis: a rare clinical presentation of sigmoid tumor].

Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to presence of malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. The authors present one case of spontaneous crepitant cellulitis in the lower abdominal wall, associated with sigmoid tumor. The patient had abdominal pain in the left iliaca fossa, fever and skin necrosis of the lower abdominal wall in the last 4 hours. At surgery they performed debridement and excision of necrotic tissue (lower abdominal wall) and partial sigmoidectomy with sigmoid colostomy. The patient died 9 months after initial surgery. A study of tumor mass revealed an adenocarcinoma. The presence of crepitant cellulitis in a lower abdominal wall should result in a search for bowel perforation.

Abdominal Muscles↗
PubMed1990

The optimum use of needle aspiration in the bacteriologic diagnosis of cellulitis in adults.

Twenty-five adult inpatients with cellulitis were prospectively studied to determine if distinctive predisposing factors, characteristic clinical findings, or specific laboratory features were predictive of isolating a pathogen from needle aspiration cultures of the leading edges of their lesions. In the univariate analysis, age, underlying disease, temperature, and white blood cell count at admission to the hospital correlated with a positive needle aspiration culture. A series of logistic regressions were performed to determine if each of these variables was independently associated with a positive needle aspiration culture. The final model demonstrated that underlying disease and body temperature were independent predictors of obtaining a positive needle aspiration culture. Consequently, the addition of white blood cell count and age failed to enhance the model's predictability. For most patients this procedure will not be helpful [corrected] in establishing a bacteriologic diagnosis. On the basis of these results, the needle aspiration technique will most likely yield pathogens in patients with underlying disease that predisposes to the acquisition of cellulitis. These patients may also fail to mount a febrile response to infection.

Adult↗
PubMed1990

[Orbital abscess as a complication of orbital cellulitis. Diagnostic value of C.A.T].

We present a case of "orbital abscess"--uncommon and severe complication of "orbital cellulitis"--in a 2 year-old female, and we consider about the etiology and pathogenesis of this process. The treatment of "orbital cellulitis" requires adequate parenteral antibiotic therapy and judicious surgical intervention, which should be planned with the results of computerized tomography in mind.

Abscess↗
PubMedDate not supplied

Periorbital cellulitis in infancy.

To our knowledge, no previous study of periorbital cellulitis has focused on its specific characteristics found only in infants (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↗
PubMed1989

Juvenile cellulitis in dogs: 15 cases (1979-1988).

The records of 15 dogs diagnosed as having juvenile cellulitis (juvenile pyoderma, puppy strangles) were evaluated for clinical, laboratory, and therapeutic results. Mandibular lymphadenopathy was observed in 14 dogs, and was not associated with skin lesions in 5 dogs. Edema, pustules, papules, or crusts were noticed periorally, periocularly, on the chin or muzzle, or in the ears of those dogs with skin lesions. Eight dogs were lethargic; fever and anorexia were inconsistent findings. Four dogs had signs of pain on manipulation of their joints. Complete blood counts revealed leukocytosis with neutrophilia in 4 dogs, and normocytic, normochromic anemia in 6 dogs. Three dogs had suppurative lymphadenitis with many neutrophils. Cytology of the aspirate of pustules or abscesses in 6 dogs revealed many neutrophils without bacteria. Coagulase-positive Staphylococcus spp were isolated from draining lesions in 2 dogs. Intact abscesses and lymph nodes were negative for bacterial growth in 4 dogs. Three of these dogs were being administered antibiotics at the time of bacterial culturing. Cytology of the aspirates of joints in 3 of the 4 dogs with joint pain revealed suppurative arthritis with no bacteria, and the aspirates were negative for bacterial growth on culturing, although all 3 dogs were being administered antibiotics at the time of culturing. Of 12 dogs initially treated with antibiotics, only 4 (33%) responded favorably; the other 8 dogs were then given antibiotics and corticosteroids. Three dogs were initially given antibiotics and corticosteroids. All dogs treated concurrently with antibiotics and corticosteroids responded favorably. One of these dogs had a relapse after treatment was discontinued. The concurrent arthritis in 4 of the dogs resolved with treatment of the juvenile cellulitis and did not redevelop once the medication was discontinued. Concurrent treatment with antibiotics (cephalosporins) and prednisone (2.2 mg/kg of body weight/day) was the most consistently effective treatment in the dogs in this study.

Adrenal Cortex Hormones↗
PubMed1989

[Diffuse spontaneous cervical cellulitis caused by anaerobic bacteria].

Nine cases of diffusal cervical cellulitis due to anaerobes were analysed. Some of them had right away extensions (to the inferior mediastinum or to the face). From these cases, the authors argue their treatment protocol. Surgery was performed immediately after diagnosis, and associated with intensive management. The excision of the necrotic tissue and the aperture of all cervical spaces (particularly the floor to the buccal cavity and the prevertebral space) were made. The source of infection was looked for (most often this being the teeth) and treated at the same time. Bacteriologic aero and anaerobic prelevements were done. A thoracic or facial surgery, being necessary because of persistency or appearance of extension, was performed secondary, after the patient was better prepared with a hyperoxygenation and a triple antibiotic therapy. Life prognosis improved with this treatment protocol. The gravity of the conditions presented by our patients depended more on the presence of an underlying disease (diabetes, immunosuppression, age...) or the delay of the diagnosis than on the cellulitis extension.

Adult↗
PubMed1989

[Gangrenous cervicofacial cellulitis of dental origin. Apropos of 11 cases].

The authors study the gangrenous cellulitis epidemiology, about 11 cases in a series of 118 odontogenic cellulitis. They insist on the frequency of the gangrenous development in old patients, and the importance of an early adapted antibiotic therapy for the vital and functional prognosis. A large surgery procedure is also necessary. At last, the ulterior treatment is depending all the more on the general signs evolution, as the local aspect.

Adult↗