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PubMed1983

[Wells' syndrome or eosinophilic cellulitis. Apropos of 2 cases. Review of the literature].

In 1971, four cases of a new dermatosis were described by Wells, under the name of recurrent granulomatous dermatitis with eosinophilia. In 1978, eight additional cases were reported by Wells and Smith and three authors suggested a shorter title: eosinophilic cellulitis for this syndrome. Since then, four additional cases were published in the literature. We report here two additional cases. From these eighteen upto now published cases, there is no doubt that this dermatosis, as initially described by Wells, is a distinct entity. Clinical course is characterized by sudden eruption of large infiltrated, itchy and/or painful plaques. Blisters are often associated. During the two or three weeks following the initial rash, the inflammatory aspect disappears. Lesions become indurated, and may resemble morphea. Spontaneous resolution occurs after about six weeks. Recurrences are constantly observed. Histologic features are a striking eosinophilic infiltrate associated with eosinophilic deposits constituting flame figures. Blood eosinophilia is present in most cases. Etiology of this entity remains unknown.

Adult↗
PubMed1983

Orbital myositis simulating infectious cellulitis: report of two cases.

Two cases of orbital myositis simulating infectious cellulitis were reported, in which the diagnosis was made by CT scans, biopsy and laboratory findings of thyroid function. In both cases, ophthalmoscopy revealed partial occlusion of the central retinal vein and choroidal folds due to posterior scleritis. Histopathology of a biopsy specimen revealed infiltration of lymphocytes, eosinophils and plasma cells and perivasculitis which suggested an allergic origin of this disease.

Aged↗
PubMed1983

Cutaneous Mycobacterium kansasii infection presenting as cellulitis.

An immunocompromised renal transplant patient developed a cellulitis-like lesion on the leg. This lesion and subsequent periarticular lesions proved to be due to Mycobacterium kansasii. Although cutaneous infection due to these microorganisms is rare, in selected cases it should be considered in the differential diagnosis.

Adult↗
PubMed1983

Clostridium perfringens cellulitis and immune-mediated hemolytic anemia in a horse.

A 10-year-old Quarter Horse mare was referred for evaluation and treatment of a large pectoral skin slough and hemoglobinuria. The skin slough was secondary to Clostridium perfringens cellulitis and associated gas gangrene. Cold hemagglutinin disease was diagnosed and was suspected to be secondary to C perfringens septicemia. The autoimmune hemolytic anemia, severe intravascular hemolysis, and hemoglobinuria were treated with dexamethasone and hydrocortisone. The infection was treated with 20 X 10(6) units of sodium penicillin, IV, 4 times daily, and the wound was debrided. When the mare relapsed, treatment was changed to 6 g of chloramphenicol sodium succinate, IV, 4 times daily. The mare died on day 11 of hospitalization, despite intensive therapy.

Anemia, Hemolytic, Autoimmune↗
PubMed1980

Orbital cellulitis of dental origin: differential diagnosis and the use of computed tomography as a diagnostic aid.

This report illustrates the spread of odontogenic infection to the orbit and the usefulness of the CT scan for the differential diagnosis of periorbital vs orbital cellulitis and abscess. It shows the necessity for close follow-up of patients with odontogenic infection so that life-endangering complications may be treated promptly. Finally, this patient illustrates the fact that, in some cases, a dental infection may be so virulent that drainage through the tooth and antibiotics do not provide control. Tooth removal and prompt incision and drainage are required for adequate treatment.

Adolescent↗
PubMed1980

Hemophilus influenzae pharyngitis and cellulitis in adults.

Hemophilus influenzae infections in adults are becoming more common but are often unsuspected in this age group by the primary care physician. Two case reports illustrate pharyngitis, and pharyngitis associated with cellulitis of the neck, in which H influenzae was cultured from the blood. The throat and skin are only two of the many sites for H influenzae infections in adults. As no physical signs are pathognomonic for this organism, its possible role should influence the choice of antibiotics while awaiting culture results. Newer cephalosporins, especially cefamandole and cefoxitin, appear promising in the treatment of these infections.

Adult↗
PubMed1981

Streptococcal submandibular cellulitis in young infants.

Six infants with streptococcal submandibular cellulitis and bacteremia were managed in our institution during a seven-month period. Five uncomplicated cases were caused by group B beta-hemolytic Streptococcus, and one rapidly progressive case of Ludwig's angina was caused by group A Streptococcus. Recognition of this characteristic clinical presentation of group B streptococcal infection may be beneficial in the management of such patients.

Ampicillin↗
PubMedDate not supplied

Sclerous atrophic cellulitis.

The author deals only with the sclerous subcutaneous inflammation caused by venous stasis. There is no clear distinction between inflammation, and tissular sclerosis, the final stage of its development. There may be a certain lesional reversibility. The term "scleroinflammatory cellulitis" is therefore quite apt. Physiopathology. Pathology venous reflex results in a flood of proteins in the interstitial tissue, and this shows in signs of tissular pain, especially at the level of the hypoderm and dermis (anatomical reasons). Clinical. This is most often in the case of women with varicose affections or with post-phlebitic syndromes causing a painful, inflamed plaque, on the surface of the inside leg, at the junction of the middle and lower thirds. As well as the inflammation of this area, adhesion to the subjacent layers and induration are also confirmed. Venous dilations may be detected at the centre of this scleroinflammatory plaque. To begin with, the skin is red and taut, but later becomes dry and atrophic. It is prone to eczema and sometimes to ulceration. The development of subcutaneous inflammation is marked by sudden manifestation of inflammation which may be extensive and results in circular suffing, in extreme cases. Varicose sclerosis can provoke sudden manifestations of inflammation and especially if the technique is faulty (excessive dosage, lack of compression, insufficient compression). Treatment. 1. Local. Bandaging and walking are imperative. The bandage must be compressive, immovable, durable, and should be reinforced as necessary at the site of the induration, by latex rubber pads. Once the object of these slightly or non-elastic pads has been achieved they can be replaced by elastic contention. 2. General. Corticoids and phenylbutazone in short courses of treatment. Other products constitute auxiliary remedies. Thermal cures are always indicated in difficult cases. Medical treatment is often enough. In certain perverse cases a surgical treatment may be required, such as hypodermal resection and ligation of the perforants. Grafts (Vigoni). Certain severe cases remain unresponsive to all treatment and in such cases it is regrettable that suitable treatment was not administered at an earlier stage.

Atrophy↗
PubMed1982

The role of high resolution computerized tomography and standardized ultrasound in the evaluation of orbital cellulitis.

We reviewed the records of 22 patients with orbital cellulitis to determine the value of high resolution computerized tomography (HRCT) and standardized ultrasound (US) in their management. In 13 patients, they demonstrated abscess formation and accurately defined its location and extent. The appearance of an abscess did not necessarily mandate immediate surgery. Three patients responded promptly to intensive antibiotic therapy and resolved despite a presumptive diagnosis of orbital abscess. The remaining 10 patients required surgical intervention and abscess formation was confirmed. In patients presenting with good visual acuity and some globe motion we recommended instituting intensive intravenous antibiotic therapy for 36 hours with close monitoring of visual acuity, avoiding surgery unless some impairment of vision is noted. The decision regarding surgery is then made on the time honored basis of response to therapy. Surgery is no necessary in those patients exhibiting prompt significant improvement in local inflammatory signs.

Abscess↗
PubMed1982

[Huge gangrenous cellulitis. Clinical symptoms-differential diagnosis--therapy].

Extensive necrotizing cellulitis occurs in adults, when body resistance is reduced by serious general disorders. Differential diagnosis should exclude the following diseases: gangrenous erysipelas, necrotizing fasciitis, gangrenous ecthyma, pyoderma gangrenosum, purpura fulminans and Coumarin necrosis. In addition to antibiotic therapy, the removal of vast necrotic areas as well as plastic covering is necessary. A case of typical predisposing disorders, clinical symptoms and development of the disease is reported.

Aged↗
PubMed1982

Management and complications of bacterial periorbital and orbital cellulitis.

Forty-four patients with periorbital cellulitis or abscess were admitted to the hospital for treatment in a five-year period. Twenty-five patients were less than 5 years old; nine were more than 20 years old. Skin infection or trauma, upper respiratory tract infection, and sinusitis were the most common predisposing causes. Staphylococcus aureus was cultured in 13 patients and Haemophilus influenzae in nine patients. Ampicillin and methicillin were the chief antibiotics used. Ten patients required surgical drainage.

Abscess↗
PubMed1981

Syndrome of pelvic cellulitis following rectal sexual trauma.

Three cases of a syndrome of pelvic cellulitis following fist fornication are described. These cases are characterized by the history of fist fornication three or more days previously, fever, pararectal induration, acute proctitis and signs of pelvic peritoneal irritation. It is important to recognize this entity as it is usually adequately treated by means of broad spectrum antibiotics. Operative intervention can usually be avoided.

Adult↗
PubMedDate not supplied

[Physiopathology of sclerous cellulitis].

Despite the erroneous and inexact term used to describe it (hypodermite scléreuse), sclerous cellulitis is a clinical, microvascular-tissular phenomenon caused by venous stasis and its lymphatico-connective sequelae. It figures in veno-lymphatic polymicroangiohistopathy, and it may be venous in origin, but the end result is cutaneous. Its clinical aspects are polymorphic, its development is long and its treatment difficult because of the histoangial substratum.

Cellulitis↗
PubMedDate not supplied

[Surgical management of veno-lymphatic cellulitis].

Out of 3511 surgical operations for venous insufficiency, 660 were on cases of lymphovenous cellulitis. The author treats the theories and techniques of such surgery emphasizing the importance of thorough pre-operatory diagnosis and of surgical technique. The author also deals with the methods used currently in hospital treatments to attain this level of thoroughness.

Cellulitis↗
PubMedDate not supplied

[Surgical management of cellulitis].

"Hypodermectomy" consists of resecting the sclerotic sub-malleolar plaque of adipose tissue, together with the responsible perforators. The operation is preceded by a long period of elastocompression. It is carried out under local anaesthetic and completed by a long or short saphenectomy, according to the case. The incision involves the entire inner surface of the leg. This long incision is vital to the reshaping of the hypodermis and the maintenance of the leg's outline. The dermis joined to the plaque has to be resected if it is much damaged. The operation thus becomes a "dermohypodermectomy". The elastocompression is continued post-operatively, with mobilisation, until complete recovery. This treatment is indicated in all cases of cellulitis (sclerotic plaque) which are not cured completely by several months' elastocompression. Age does not constitute a contra-indication, as long as there is no arteriopathy.

Adipose Tissue↗
PubMed1995

[Cervico-facial cellulitis of oral and dental origin: study of 26 cases at the Lomé University Hospital].

The authors report 26 cases of cervico-facial cellulitis of mouth and dental origin. They highlight the severity of those affections. The original entry is dental caries in 88.4% of cases. Adequate treatment consisting of a surgical drainage, a suppression of the original entry and antibiotherapy combining a penicillin, an aminoglycosid and metronidazol. Preventive therapeutic measures are prescribed.

Adolescent↗
PubMed1994

Magnetic resonance imaging in adults presenting with severe acute infectious cellulitis.

BACKGROUND AND DESIGN: Early categorization of some acute soft-tissue infections, such as severe infectious cellulitis (IC) without or with secondary abscess formation, necrotizing fasciitis (NF) or pyomyositis, is frequently difficult. The first one requires only medical treatment, the remaining ones require either surgery or closed drainage. To determine the presence and the extent of these infections early, we have prospectively studied the value of magnetic resonance imaging in patients admitted for IC with local or general criteria of severity. Images were analyzed on a blind basis. Definite diagnosis was obtained by reviewing clinical records and, in most patients, the results of an invasive procedure. RESULTS: Twenty-six patients (56 +/- 23 years old) were included in this study. Among them, 13 received gadolinium-diethylene-triaminepenta-acetic acid intravenously. The final diagnosis was pyomyositis (five patients), NF (three patients), or IC with (seven patients) or without (11 patients) subcutaneous abscess. Images specific for these diseases were best outlined with T2-weighted sequences. In patients with pyomyositis or subcutaneous abscess(es), we observed spindle-shaped or round, well-defined areas of high signal intensity within the muscles or subcutis, respectively. Patients with NF exhibited numerous homogeneous, well-defined dome-shaped areas of hypersignal in the deep hypodermis. In patients with uncomplicated IC, these dome-shaped areas of hypersignal appeared ill-defined, heterogeneous, smaller, thinner, and less numerous than those in patients with NF. CONCLUSIONS: In patients presenting severe IC, magnetic resonance imaging provided an early clue in the diagnosis of pyomyositis, NF, and abscess-complicated IC. By precisely defining the extent of these infections, it helped to plan surgical treatment.

Abscess↗
PubMedDate not supplied

[Orbital cellulitis and permanent amaurosis: clinical case].

Orbital cellulitis is a rare, potentially serious but complication of acute sinusitis. It is more frequent and benign in children, but in adults usually requieres surgical drainage of the affected sinus. We report a case of aggressive evolution with permanent blindness in an adult without general or local risk factors, in spite of adequate treatment. The literature is reviewed.

Acute Disease↗