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At least 19 recordsLinked to original sources
PubMed2003

Bacteremic pneumococcal cellulitis compared with bacteremic cellulitis caused by Staphylococcus aureus and Streptococcus pyogenes.

In order to better characterize bacteremic cellulitis caused by Streptococcus pneumoniae, a review was conducted of 10 cases of bacteremic pneumococcal cellulitis, which represented 0.9% of all cases of pneumococcal bacteremia (n=1,076) and 3.2% of all cases of community-acquired bacteremic cellulitis (n=312) that occurred in the Hospital de Bellvitge, Barcelona, from 1984 to 2001. In addition to these 10 cases, 28 cases of bacteremic pneumococcal cellulitis from the literature (Medline 1975-2001) were reviewed. Pneumococcal cellulitis of the face, neck, and trunk was observed more frequently in patients with systemic lupus erythematosus and hematologic disorders, while pneumococcal cellulitis of the limbs was more common in patients with diabetes, alcoholism, and parenteral drug use. In the Hospital de Bellvitge group, bacteremic cellulitis due to Streptococcus pneumoniae was more frequently associated with severe underlying diseases than that due to Staphylococcus aureus or Streptococcus pyogenes (100%, 57%, and 72%, respectively;P=0.01). A concomitant extracutaneous focus of infection (e.g., respiratory tract infection) suggesting hematogenous spread with metastatic cellulitis was more frequent in patients with pneumococcal cellulitis, while a local cutaneous entry of microorganisms was feasible in most patients with Staphylococcus aureus or Streptococcus pyogenes cellulitis. The 30-day mortality was 10% in patients with pneumococcal cellulitis, 13% in patients with Staphylococcus aureus cellulitis, and 23% in patients with Streptococcus pyogenes cellulitis (P=0.3). Thus, bacteremic pneumococcal cellulitis is an unusual manifestation of pneumococcal disease and occurs mainly in patients with severe underlying diseases. In most cases, pneumococcal cellulitis has a different pathophysiologic mechanism than cellulitis caused by Staphylococcus aureus or Streptococcus pyogenes.

Adult↗
PubMedDate not supplied

Description of cellulitis lesions and associations between cellulitis and other categories of condemnation.

A total of 110 broiler flocks processed in a single processing plant in southern Ontario were studied for purposes of describing the cellulitis lesions and investigating possible associations between cellulitis and other categories of condemnation at the processing plant. Two hundred and ninety-five carcasses condemned for cellulitis were examined. They came from 65 of the 110 flocks. The lesions tended to be unilateral with most carcasses (87%) having one lesion. The majority of the lesions (92%) were located on the abdomen. Almost 65% of the lesions were large (> or = 8.1 cm2), and 27% were medium (2.1-8.0 cm2). On the basis of gross appearance, 69% of the lesions were classified as severe, 26% moderate, and 5% mild. Of 149 lesions examined histologically, 74% were classified as chronic, 21% ongoing, and 5% mild-acute. Condemnation data from the 110 broiler flocks were analyzed using Poisson regression. Simple relationships were examined between a count outcome (number of cellulitis-condemned carcasses per flock) and other categories of condemnation and average bird weight. Cellulitis was significantly associated with average bird weight (P = 0.0018), Escherichia coli-related conditions (SEROSITIS; P < or = 0.0001), ascites (P = 0.0004), cyanosis (P < or = 0.0001), valgus varus deformity (P < or = 0.0001), REJECT (combined carcass condemnations for bruising, mutilation, and contamination; P = 0.0003), and the interaction terms "average bird weight and ascites" (AVWT*ASCIT; P < or = 0.0001) and "average bird weight and cyanosis" (AVWT*CYAN; P < or = 0.0001). Average bird weight, SEROSITIS, ascites, cyanosis, valgus varus deformity, and AVWT*ASCIT were the only significant factors after adjusting for clustering. No association was observed between cellulitis and emaciation and dead on arrival. Variables significantly associated with cellulitis in the multivariate analysis could be considered as potential predictors. These predictors may share common risk factors predisposing broiler chickens to cellulitis.

Abattoirs↗
PubMed1987

The acute orbit. Preseptal (periorbital) cellulitis, subperiosteal abscess and orbital cellulitis due to sinusitis.

The clinical picture of an acute orbit, as manifest by preseptal cellulitis, subperiosteal abscess or orbital cellulitis, is still frequently seen in ENT practice. The commonest cause is sinusitis and the authors advocate early surgical intervention in acute orbits due to sinusitis. Clinically, it can be difficult to distinguish between a subperiosteal abscess and orbital cellulitis and a CAT scan may be helpful. Surgically, a subperiosteal abscess is the more important (and probably more frequent) entity as it may require drainage. It may be suspected in an acute orbit which progresses rapidly or fails to settle on treatment and it may require drainage to allow the condition to resolve and avoid potentially damaging sequelae. A classification of the stages of the inflammatory processes seen in the acute orbit is given and the management of 34 cases due to sinusitis is discussed. The other causes of acute orbits are discussed and the further complications that may occur are also mentioned. Blindness, cavernous sinus thrombosis and cerebral involvement are still frequently recorded and death may still occur.

Abscess↗
PubMed1986

Orbital cellulitis and preseptal cellulitis in childhood.

A study was made of 112 children with preseptal cellulitis, orbital cellulitis, subperiosteal abscess, and orbital abscess. These were consecutive admissions to the Royal Alexandra Hospital for Children, Sydney, during the period June 1976 to August 1985. The average age was 3 years 6 months. The clinical and radiological signs for each group were defined. Of the 112 children, 43.8% (with an average age of 3 years 3 months) had a clinical history of an upper respiratory tract infection. Trauma was a factor in 13.4% of patients. Haemophilus influenzae was recovered from blood culture in two patients and from conjunctival culture in seven patients. The average age of this group was 3 years 7 months. Plain radiographs taken of 53 patients revealed evidence of paranasal sinus disease in 29 (54.7%). Computerized tomography was performed in 14 patients. Of seven patients requiring surgical drainage of orbital or subperiosteal abscess (average age 7 years 2 months), five had clinical upper respiratory tract infection.

Abscess↗
PubMed2001

Purulent pansinusitis, orbital cellulitis and rhinogenic intracranial complications.

Objectives: Acute pansinusitis is rarely seen in the maxillofacial surgery field, but often occurs in combination with orbital and intracranial involvement. Clinically this entity is of great importance, since it represents a severe disease with possibly disastrous consequences. Patients: Aetiology, diagnosis and therapy of acute pansinusitis and its complications were analysed in 36 patients treated surgically from 1987 to 1996. Results: Eighteen patients were aged between 3 and 21-years-old. Only eight suffered from pure pansinusitis, and three of an isolated purulent orbital infection. Of these 25 patients 20 had (pan-)sinusitis with orbital, three with intracranial, and two with both orbital and intracranial complications. Intracranial involvement included meningitis, empyema and brain abscess. Aetiology was rhinogenic in 26, odontogenic in six patients, and traumatic in two cases. Radiological work-up included conventional radiographs and CT in most cases, MRI was only used with special indications. Microbiological examination detected single or multiple species of micro-organisms with equal frequency. If multiple species were found, infection was mostly aerobic/anaerobic in combination. Conclusion: These purulent processes, frequently seen in young patients, require immediate surgical intervention and drainage with elimination of the cause of the disease if possible. Cooperation with other specialities is essential depending on the spread of the disease. In spite of the threatening acute symptoms, severe courses of disease or permanent defects should be avoidable. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed1978

Differentiation of orbital cellulitis from preseptal cellulitis by computed tomography.

Computed tomography (CT) was used in the management of four patients with periorbital inflammation. These patients were selected for CT scanning because of the difficulty, on clinical examination alone, in determining the degree of orbital disease. The CT scans confirmed the presence and defined the location of an orbital abscess in three patients and eliminated the presence of an abscess in the fourth. On the basis of this experience, CT scanning is recommended in the evaluation of children with periorbital inflammation in whom proptosis, ophthalmoplegia, or loss of visual acuity develops, or in whom severe eyelid edema prevents adequate eye examination.

Adolescent↗
PubMedDate not supplied

Assessing cellulitis pathogenicity of Escherichia coli isolates in broiler chickens assessed by an in vivo inoculation model.

The purpose of this study was to identify Escherichia coli isolates that could be characterized as cellulitis pathogens. Twelve E. coli isolates from diagnostic cases of cellulitis or mixed infections with various serotypes were compared for ability to produce cellulitis and internal lesions indicative of systemic infection. Ranking of isolates was based on the premise that E. coli isolates that were "cellulitis-type" would cause cellulitis lesions without causing systemic infection. A quantitative scoring system was also used so both the time required for a lesion to develop and lesion severity could be evaluated as determinants of virulence. Escherichia coli isolates were inoculated by subcutaneous injection of a standardized dose in 24 broiler chickens per isolate. Necropsy was performed on four birds per group at 6, 12, 24, 36, 48, and 60 hr postinoculation (PI). Cellulitis lesions were scored on a 0 to 5 scale based on size, migration from the inoculation site, and gross characteristics. Lesions of the pericardium, liver, joint, or body cavity were evaluated. Gross lesion scores of 1 or 2 were evident by 6 hr PI with all isolates. Mortality occurred in 4 of 12 experimental groups. Internal lesions were observed in 3 to 12 birds per group. Escherichia coli was reisolated from all lesions. The four isolates with the highest lesion score and highest lesion points as determined by the quantitative scoring system did not vary. However, the rankings of two other isolates were affected. Four isolates that were below average for mean internal lesion score and above average for mean cellulitis points were characterized as cellulitis-type. Three isolates that were above average for internal lesion score and below average for mean cellulitis points were characterized as systemic-type. The E. coli serotype was not a determining factor for cellulitis-type pathogenicity. Isolates discriminated as cellulitis-type or septicemic-type E. coli in this study are being used to further investigate virulence factors involved in the pathogenesis of cellulitis in broiler chickens.

Animals↗
PubMed1986

Clinical implications of orbital cellulitis.

Periorbital and orbital cellulitis are clearly two distinct disorders with different etiologies. Periorbital cellulitis is well-documented as a more common infectious process limited to the eyelids in the preseptal region. In contrast, orbital cellulitis represents a more severe, but less common, infection of the orbit posterior to the septum with or without subperiosteal abscess, orbital abscess, or cavernous sinus thrombosis. A retrospective review of the clinical and laboratory data of 137 cases of orbital and periorbital cellulitis was performed. Periorbital cellulitis was documented in 98 cases (71%), in contrast to orbital cellulitis which was noted in 39 (28%) patients. All patients with orbital cellulitis received intravenous antibiotics, however, surgical therapy was necessary for progression of orbital cellulitis in 49% of patients. The majority of patients underwent incision and drainage of an abscess in the orbit. Complications as a result of orbital cellulitis occurred in nine (23%) of the patients. A distinction is made between the clinical entity of periorbital cellulitis and orbital cellulitis. Separating these clinical entities on the basis of physical examination and radiographic studies is important because the medical and surgical management of these two disease processes is different.

Abscess↗
PubMed1996

The dilemma of delayed cellulitis after breast conservation therapy.

OBJECTIVE: To determine the clinicopathologic characteristics of patients with breast cancers in whom delayed breast cellulitis developed after conservation therapy (lumpectomy, axillary dissection, and radiation). BACKGROUND: Breast cellulitis developing after conservation therapy represents a difficult diagnostic and management dilemma because determination of its origin may be necessary before further treatment decisions can be made. METHODS: In this retrospective evaluation of 184 sequential patients with breast cancers who underwent conservation therapy, 10 study patients (5%) in whom breast cellulitis developed 3 or more months after surgery were compared with the 174 patients in whom cellulitis did not develop. RESULTS: There was no significant difference in clinicopathologic characteristics of the study patients compared with control patients. The cellulitis resolved in 5 patients (50%) and persisted from 4 months to more than 1 year in 5 patients (50%). The cellulitis recurred in 1 patient who responded to repeated therapy. The 5 patients with persistent cellulitis underwent biopsies, and recurrent cancer was found in 1 patient. Recurrent cancer did not develop in the patients whose cellulitis resolved within 4 months with a minimum follow-up of 24 months. CONCLUSIONS: Delayed-onset cellulitis occurs in a small percentage of patients with breast cancers treated by conservation therapy. The cellulitis may take several weeks to clear, and/or it may recur or persist. If the condition persists after 4 months of therapy, a biopsy should be performed to rule out recurrent cancer.

Adult↗
PubMedDate not supplied

Histopathologic and bacteriologic evaluations of cellulitis detected in legs and caudal abdominal regions of turkeys.

The objective of this study was to identify the causative agent of cellulitis in turkeys. Eighteen flocks from nine producers were sampled at the local processing plant, and 37 birds with cellulitis on legs or caudal thoracic area were obtained. None of the 37 birds with cellulitis had lesions in other organs. On gross examination, lesions were categorized into two groups: cellulitis with unopened skin lesions (type a) and cellulitis with opened skin lesions (type b). Histopathologically, cellulitis with unopened skin lesions had dermal necrosis with underlying fibrin and inflammatory exudate but cellulitis with open skin lesions had chronic granulomatous/granulation tissue-type reaction associated with foreign material. A complete bacteriologic study was conducted on 25 of 37 birds. Bacteria were isolated from 12 of the 25 birds with cellulitis lesions. No aerobic, microaerophilic, or anaerobic bacteria were isolated from the remaining 13 birds with cellulitis lesions. Escherichia coli was isolated in low numbers in mixed cultures with Proteus mirabilis, Lactobacillus spp., Klebsiella spp., and Staphylococcus spp. in 9 of 12 lesions. The remaining few cases yielded P. mirabilis in pure culture or in mixed culture with Pseudomonas aeruginosa. Types a and b cellulitis lesions in turkeys could be associated with primary contact dermatitis and skin abrasions, respectively. Their occurrence is likely associated with different management practices.

Abdomen↗
PubMed2002

Facial cellulitis in childhood: a changing spectrum.

BACKGROUND: Before conjugated Haemophilus influenzae type b (Hib) vaccination, a syndrome known as buccal cellulitis, usually caused by Hib and often accompanied by bacteremia, was seen. We investigated the incidence and cause of facial cellulitis at our hospital during the 10 years before and the 10 years after introduction of the vaccine. METHODS: Records of patients discharged with a diagnosis of facial cellulitis or infections of the oral cavity were reviewed. Fisher's exact test was used to compare rates of cellulitis during the two decades. RESULTS: Trauma was the most common antecedent to facial cellulitis in both eras. Buccal cellulitis accounted for 7/25 (28%) of cases before Hib vaccination and 0/19 cases since. Pneumococcal buccal cellulitis was not seen in either decade. CONCLUSIONS: Buccal cellulitis due to Hib is a disappearing disease. Eighty-nine percent of recent inpatient cases of childhood facial cellulitis were related to trauma, tooth problems, or severe sinusitis. Facial cellulitis due to S pneumoniae is rare.

Bacteremia↗
PubMed1994

Breast cellulitis after conservative surgery and radiotherapy.

PURPOSE: Cellulitis is a previously unreported complication of conservative surgery and radiation therapy for early stage breast cancer. Patients who presented with breast cellulitis after conservative therapy are described. METHODS AND MATERIALS: Eleven patients that developed cellulitis of the breast over a 38-month period of observation are the subject of this report. Clinical characteristics of patients with cellulitis and their treatment and outcome are reported. Potential patient and treatment-related correlates for the development of cellulitis are analyzed. RESULTS: The risk of cellulitis persists years after initial breast cancer therapy. The clinical course of our patients was variable: some patients required aggressive, long-duration antibiotic therapy, while others had rapid resolution with antibiotics. Three patients suffered from multiple episodes of cellulitis. CONCLUSION: Patients with breast cancer treated with conservative surgery and radiotherapy are at risk for breast cellulitis. Systematic characterization of cases of cellulitis may provide insight into diagnosis, prevention, and more effective therapy for this uncommon complication.

Acute Disease↗
PubMed2000

Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination.

OBJECTIVE: To evaluate the effect of the introduction of the Haemophilus influenzae B (Hib) vaccine (introduced first in 1985, then extended in 1990 to children at least 2 months of age) on the epidemiologic features of periorbital and orbital cellulitis. DESIGN: Retrospective, comparative case series. PARTICIPANTS: Three hundred fifteen pediatric inpatients. METHODS: Children at Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary with discharge diagnosis of periorbital or orbital cellulitis from 1980 through 1998 were reviewed. MAIN OUTCOME MEASURES: Case rate, culture-positive isolates, and associated conditions. RESULTS: A total of 297 cases of periorbital cellulitis and 18 cases of orbital cellulitis were reviewed. Before 1990, there were 27 cases of Hib-related cellulitis (11.7% of total in that period), whereas after 1990, there were only three (3.5% of total; P = 0.028). The number of cases per year was significantly lower after 1990 (21.2 +/- 10.4 vs. 8.7 +/- 3.9; P = 0.008), as were the number of positive culture isolates (for any organism) after 1990 (76 [33. 0%] vs. 9 [10.6%]; P < 0.001). The medical conditions most commonly associated with periorbital cellulitis were sinusitis (44 [14.5%]) and upper respiratory infections (73 [26.6%]). All cases of orbital cellulitis were associated with sinusitis. CONCLUSIONS: The introduction of the Hib vaccine coincided with a sharp decline not only in the number of periorbital and orbital cellulitis cases related to H. influenzae, but also in the annual case rate. These data are consistent with a facilitative role for H. influenzae in the development of cellulitis secondary to other pathogens. They also may support restriction of the spectrum of antibiotics used to manage these conditions.

Cellulitis↗
PubMed1998

Preseptal and orbital cellulitis in childhood. A changing microbiologic spectrum.

OBJECTIVE: The authors sought to determine whether the microbiologic spectrum of preseptal and orbital cellulitis had changed over the past decade. DESIGN: A retrospective chart review of all inpatient and outpatient children with an ICD-9 diagnosis of preseptal or orbital cellulitis seen at Vanderbilt University Medical Center since the introduction of the Haemophilus influenzae type-B (HiB) vaccine (1986-1996). MAIN OUTCOME MEASURES: Blood and abscess cultures from children with preseptal and orbital cellulitis were tabulated. RESULTS: During this period, 70 cases of preseptal cellulitis were seen. Blood cultures were obtained in 59 cases; only 6 were positive. Five cultures grew Streptococcus species. The one positive H. influenzae culture occurred in 1987 in a child who did not receive the HiB vaccine. There have been no new patients with preseptal cellulitis and H. influenzae bacteremia at Vanderbilt for 10 years. There were ten cases of orbital cellulitis, of which blood or abscess or both were cultured in eight. Six cases had positive cultures. Four cultures grew Streptococcus species. The other two grew H. influenzae and mixed H. influenzae/gram-positive cocci. CONCLUSION: The incidence of hemophilus-associated bacteremia in patients with preseptal cellulitis has decreased dramatically over the past 10 years. Streptococcus species now are the predominant cause. Orbital cellulitis due to H. influenzae may still occur, but it is much less likely. A more conservative approach to the diagnosis and management of preseptal and orbital cellulitis may be warranted.

Adolescent↗
PubMedDate not supplied

Trends in cellulitis condemnations in the Ontario chicken industry between April 1998 and April 2001.

We conducted a retrospective study to determine the prevalence of cellulitis condemnations in the Ontario chicken industry and the relative proportion of variation attributable to factors that vary between processors, producers, and lots and over time. The time span studied was April 1998 to April 2001. We obtained condemnation data randomly from the Chicken Farmers of Ontario and analyzed the data with a generalized mixed model. The (weighted) average prevalence of cellulitis in Ontario between April 1998 and 2001 was 0.94% (0.87%, 1.03%). The prevalence of cellulitis ranged from 0% to 14.9%, with one outlier at 30% and 95% of the data between 0 and 2.58%. The final mixed model we used to describe the variation in the prevalence of cellulitis between lots included random effect terms, the plant where the birds were processed, the producer, the quota period when the birds were processed, and the interaction term quota period by processing plant, as well as fixed effects terms, the type of inspection system and the average weight of the birds. The final model containing these variables explained approximately 78% of the total variation in the data. Our findings indicate all three random effects variables accounted for a significant amount of variation in the cellulitis data; however, the greatest source of variation was ascribed to the plants where the birds were processed. Some of the variation in cellulitis associated with processing plants was explained by the type of inspection system used by the plant, but even after controlling for this factor, there remained a relatively large amount of variation between processing plants (approximately 30%). These findings suggest there may be discrepancies in the diagnoses of the condition. Some of the variation in the prevalence of cellulitis (approximately 13%) was also attributed to the producer; however, more of the variation in the data was attributed to differences in lot-specific factors (approximately 22%). Therefore, future control efforts for cellulitis should focus on standardizing the classification of cellulitis at processing plants and identifying lot specific factors that may increase the risk of the condition.

Animals↗
PubMed1994

[Orbital cellulitis in children].

BACKGROUND: Because the potential for complications is great, orbital cellulitis must be recognized promptly and treated aggressively. POPULATION AND METHODS: The files of 38 children admitted from 1988 to 1993 because of orbital or periorbital cellulitis were retrospectively analyzed. Clinical findings included fever, edema, pain, rhinorrhea, conjunctivitis, limitation of eye movement, loss of vision and ophthalmoplegia. All patients had hemogram, ionogram, blood cultures, search for soluble antigens in blood and/or urine, C-reactive protein measurement; they also had roentgenographic examination of the sinuses, orbital ultrasonography and/or CT scan in patients with retroseptal cellulitis. All patients were given systemic antibiotic therapy. RESULTS: Thirty-five patients had preseptal and three retroseptal cellulitis. Preseptal cellulitis was associated to sinusitis in 17 patients, to ocular infection in 11 (seven conjunctivitis and four dacryocystitis), to an infected wound in six. Seventy-three per cent of the patients with ocular infection were less than 2 years of age with a significant preponderance of girls (64%). The three cases of retroseptal cellulitis were associated to sinusitis. Orbital echography was performed in five cases, permitting to recognize the three cases of retroseptal cellulitis that was confirmed by CT scan. Twenty-five of the 38 children were given oral antibiotics during the days preceding admission, explaining the relative rarity of positive bacteriological findings (seven cases). Thirty-five of the 38 children were given IV cefotaxime + fosfomycin, associated to netromycin in 16 cases. Mean duration of treatment was 3 days (range: 1-7). IV antibiotherapy was followed by oral amoxicillin-clavulanic acid administration in 25 patients and pristinamycin in 11. CONCLUSIONS: Orbital cellulitis in children, more frequently preseptal, have a good prognosis under adapted antibiotherapy. A retroseptal cellulitis requires multidisciplinary management because of the risk of extension of infection from the orbit to the eye and/or into the cranial cavity.

Anti-Bacterial Agents↗