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Hemophilus orbital cellulitis and panophthalmitis simulating mucormycosis.

A 47-year-old uncontrolled diabetic presented with proptosis, pain, immobility of the globe, and a perforated corneal ulcer. The clinical impression of mucormycosis was erroneous. Hemophilus aegyptius was grown from the orbit, the vitreous and oropharynx. This is believed to be the first report of panophthalmitis due to this organism.

Cellulitis↗

[Severe diffuse facial cellulitis].

Twenty cases of severe cervicofacial infections among 184 cases of cellulites treated in 1991 and 1992 at the Lille University Hospital were investigated. Outcome was compared with results reported in the literature. Outcomes were similar and emphasized the critical nature of this type of infection which caused 7 deaths in our series and severe anatomic and functional sequelae. All patients (n = 20) were given anti-inflammatory drugs prior to surgery. The correlation between disease severity and use of anti-inflammatory drugs would appear to be an established fact. Criteria predicting severity were identified in order to obtain a score for high or low risk and to better adapt the medical and surgical management strategy.

Adolescent↗

March cellulitis.

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Cellulitis↗

[Necrotizing cervico-mediastinal cellulitis. Apropos of 3 cases].

OBJECTIVE: To outline the most appropriate treatment of descending necrotizing mediastinitis. MATERIALS AND METHODS: Three adult patients had mediastinitis occurring from a descending odontogenic infection in one case and oropharynx infection in two cases. All patients underwent extensive surgical debridement and a cervicomediastinal drainage through a cervical incision. All patients survived. DISCUSSION: Soft-tissue infections of the neck with mediastinitis demand early diagnosis aided by CT scan in order to decrease their threat to life. Extensive surgical debridement and a cervico mediastinal drainage through a cervical incision is adequate when mediastinitis is limited to the upper mediastinum. Thoracotomy has to be performed when the process spread below the carina. Patients must be treated initially aggressively with the aid of multidisciplinary support team (intensive care physicians, thoracic and head and neck surgeons). Early surgery must treat both neck and mediastin. While usually associated with greater than 40% mortality, all the patients in this series survived.

Adult↗