Postoperation of preauricular fistula cellulitis caused by methicillin-resistant staphylococcus aureus infection

A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for the wound, presented with MRSA infection. The patient was treated with linezolid for three days. Her pain and paresthesia resolved, and C-reactive protein decreased to normal.

Odontogenic Cervico-Facial Cellulitis at the University Hospital of Brazzaville: About 431 Cases

Context and Objective: Cellulitis is potentially serious polymicrobial infections that can be life-threatening for the patient. They are clearly increasing in our service. It is with the aim of determining the hospital frequency of cellulitis of dental origin epidemiological profile, describing the clinical types, the therapeutic modalities and evaluating the results obtained. Subjects and Methods: This is a retrospective descriptive study on the files of 431 hospitalized patients, between January 2010 and December 2018 in the department of stomatology and maxillofacial surgery of the University Hospital of Brazzaville (Congo). The studied parameters: The frequency, the age, the gender, the origin, the consultation average time, the contributing factors, the entrance gate, the seat, the paraclinical assessment, the therapeutic modalities and the evolution. Results: Cervico-facial cellulitis accounted for 32.8% of hospitalizations. The average age was 32.8 ± 1.98 years, ranges from 3 to 93 years. The predominance was male with 241 cases, or 55.9%. 64.73% of patients came from CHUB emergencies. The mandibular seat was dominant with 77.72% of cases. The average consultation time was 6 days. As a contributing factor, we found the consumption of nonsteroidal anti-inflammatory drugs (NSAIDs). Tooth decay was the most common etiology 92.5%. Antibiotic therapy and surgery had a good evolution in 96.8% of cases. The mortality rate was 3.3%. Conclusion: odontogenic cervicofacial cellulitis remains common in daily practice. Patient care should focus on the preventive component integrating patient awareness of oral health.

Facial Cellulitis of Dental Origin: Experiments from the University of BouakéHealth Centre (Cote d’Ivoire)

Context: Facial cellulitis of dental origin is relatively frequent and severe. Objective: The aim of this document to describe the epidemiological, clinical, therapeutic and evolutionary aspects of facial cellulitis of dental origin in Bouaké. Methodology: This was a retrospective and descriptive study carried out in the stomatology and maxillofacial surgery department of the University of Bouaké Health centre over a period of 19 months (January 2018 to October 2019). All patients with facial cellulitis of dental origin were included. The parameters studied were epidemiological, clinical, therapeutic and evolutionary. Results: 179 patients were collected (hospital prevalence of 20.79%). The average age was 34 years (min 1-year-old and max 80-year-old). The sex ratio was 1.18. Among the patients, some were craftsmen (31.28%) and others were farmers (21.79%). The favourable factors included the nonsteroidal anti-inflammatory (77.65%) and traditional therapeutics (44.13%). The average number of days before consultation was 13 days (min 1 day and max 75 days). There were 7 cases of chronic cellulitis (3.91%) and 172 cases of acute cellulitis, including 107 (62.21%) circumscribed cellulitis, 51 (29.65%) diffused cellulitis, and 14 (8.14%) necrotizing fasciitis. The causal lesion was tooth decay (96.09%) and dental avulsion without antibiotherapy (3.91%). Incision and drainage was made in 145 patients (81%) necrosectomy surgery in 54 patients (30.17%). The mortality rate was 13.96%. Conclusion: Facial cellulitis of dental origin are clinically polymorphic with significant mortality prompting increased dental decay prevention actions.

Helicobacter cinaedi bacteremia with cellulitis after ABO-incompatible living-donor liver transplantation: Case report

Helicobacter cinaedi(H. cinaedi), a Gram-negative spiral-shaped bacterium, is an enterohepatic nonHelicobacter pylori Helicobacter species. We report the first case of H. cinaedi bacteremia with cellulitis after liver transplantation. A 48-year-old male, who had been a dog breeder for 15 years, underwent ABO-incompatible living-donor liver transplantation for hepatitis C virus-induced decompensated cirrhosis using an anti-hepatitis B core antibody-positive graft. The patient was preoperatively administered rituximab and underwent plasma exchange twice to overcome blood type incompatibility. After discharge, he had been doing well with immunosuppression therapy comprising cyclosporine, mycophenolate mofetil, and steroid according to the ABO-incompatible protocol of our institution. However, 7 mo after transplantation, he was admitted to our hospital with a diagnosis of recurrent cellulitis on the left lower extremity, and H. cinaedi was detected by both blood culture and polymerase chain reaction analysis. Antibiotics improved his symptoms, and he was discharged at day 30 after admission. Clinicians should be more aware of H. cinaedi in immunocompromised patients, such as ABO-incompatible transplant recipients.

Complications of Cervicofacial Cellulitis Supported in University Hospital Yalgado Ouedraogo

Introduction: The complications of cervicofacial cellulitis are one of the most serious emergencies Oto-Rhino-Laryngology (ORL). These complications are still observed in our context despite the advent of antibiotics. The aim of our study was to describe the clinical presentation and management of patients admitted to our institution for complications of cervicofacial cellulitis. Patients and Methods: It came from a retrospective study in the ORL service, a department of Yalgado Ouédraogo Hospital of Ouagadougou, between January 2005 and December 2014, during which all patients with cervicofacial cellulitis complications were identified. Results: We collected over 10 years, 69 cases of complicated cellulitis, a frequency of 54.3% of cervicofacial cellulitis and 2.3% of all hospitalizations. The group included 33% women and 67% men to 29 years of average age. The non-steroidal anti-inflammatory isolated was the main factor contributing 59.4%. The front door was mainly dental 43.5% and pharyngeal 36.2%. The most frequent complications were mediastinitis thoracic dissemination 24.6%, sepsis 21.7% and spontaneous fistula 20.3% with orostome or pharyngostome. Medico-surgical treatment was associated with a reanimation in most cases. The outcome was favorable in 79.7% of cases. Mortality was 17.4%. Conclusion: The complications of cervicofacial cellulitis are frequent and often life-threatening. Their management is done in a multidisciplinary framework. The prevention and early treatment remain the pledge of their control.

Histiocytoid giant cellulitis-like Sweet syndrome at the site of sternal aspiration:A case report and review of literature

BACKGROUND Giant cellulitis-like Sweet syndrome(SS) is a rare subtype of SS,and reports of the combined histiocytoid type of pathology are scarce.Here,we report a case of SS with distinctive clinical presentations and which was difficult to distinguish from cellulitis.By sharing this case and a discussion of the related literature in detail,we aim to provide clinicians with new insights into the characteristics of histiocytoid giant cellulitis-like(HGC)-SS and the pathogenesis of SS.CASE SUMMARY A 52-year-old male was admitted after experiencing progressive fatigue for 1 mo and tongue swelling with pain for 1 d.He was diagnosed with myelodysplastic syndrome(MDS) and angioneurotic edema of the tongue and floor of the mouth.However,7 d after examination by sternal aspiration,a violaceous,tender,and swollen nodule developed at the site,with poorly demarcated erythema of the surrounding skin.Considering his profile of risk factors,the diagnosis of cellulitis was made and he was administered broad-spectrum antibiotics.When the lesion continued to worsen and he developed chills and fever,pathogenic and dermatopathological examination led to the diagnosis of HGC-SS.Treatment with prednisone led to the fever being relieved within 24 h and the skin lesion being resolved within 1 wk.The patient refused intensive treatment and was instead given thalidomide,erythropoietin,stanozolol,and supportive care.The prednisone was gradually tapered,with no signs of recurrence,but he died 2 mo later of severe pneumonia.CONCLUSION HGC-SS demonstrates unique manifestation.SS and leukemia cutis share cytological origin.Myelofibrosis and SS are adverse prognostic factors for MDS.

Endogenous Endophthalmitis Associated with Facial Cellulitis After a Tongue Bite

Endogenous endophthalmitis is an intraocular infection that results from hematogenous spread of organisms from a distant source of infection. Facial cellulitis is rarely reported as a focus of infection. We report a case of 51-year-old unconscious woman presenting with fever, facial swelling, and decreased visual acuity secondary to facial cellulitis, endogenous endophthalmitis and end-stage renal disease(ESRD). Generally systemic antibiotics in endophthalmitis have low efficacy because of the blood-ocular barrier. The management of endophthalmitis begins with intravitreal antibiotic injections and if the response is not favorable to do a vitrectomy. Twelve hours after the intravitreal antibiotic injection, vitrectomy was considered because of worsening of the vitreal cloudiness. However, the patient's general medical condition precluded vitrectomy. We experienced successful treatment with intravitreal antibiotic injection and continuous intravenous antibiotic administration because of the breakdown of the blood-ocular barrier due to ocular inflammation, especially in the setting of systemic vascular and fluid homeostatic changes.

Late-onset Orbital Cellulitis with Abscess Formation Caused by Klebsiella Pneumoniae

Klebsiella pneumoniae is a facultative anaerobic gram-negative, non-motile, capsulated, gas-producing rod found widely in nature and often associated with urinary and respiratory infections in humans. Orbital cellulitis with abscess formation caused by K. pneumoniae is rare. Here, we present a case of K. pneumonia-inducing orbital cellulitis with abscess formation in a patient who had undergone an orbital wall fracture prosthesis with hydroxyapatite implantation due to orbital trauma 9 years ago. The patient was treated successfully with antibiotics and surgery.

Haematological and Biochemical Variations in Cervico-Facial Cellulitis of Dental Origin in the City of Ouagadougou (Burkina Faso)

Background: Cervicofacial cellulitis is a severe infection and is responsible for a major disruption of host homeostasis. The aim of this work was to describe the haematological and biochemical variations of cervico-facial cellulitis. Methods: This was a cross-sectional study conducted from 1 January to 31 December 2020. All patients hospitalized for cervico-facial cellulitis of dental origin were included in the study. The usual parameters of descriptive statistics were estimated for each variable. Results: Our sample consisted of 166 patients. The average age of patients with cervicofacial cellulitis in our study was 39.9 ± 15.39 years. Red blood cell count was low in 55.5% of patients and hyperleukocytosis was noted in 89.16% of patients. Platelets were normal in 43.14% of patients and 78.43% of patients had a low haematocrit (haemodilution). Anemia was noted in 64.7% of patients. In addition, 61.0% of patients had elevated uricemia and 31.17% had elevated creatinemia. Conclusion: Cellulitis is still a common condition in less privileged environments. Its diagnosis can be guided by clinical and biological findings. Consistent education of the population on oral health, and the control of biological disorders that result from it, are sufficient to greatly reduce its prevalence and the appearance of complicated forms.

Epidemiological Aspects of Cervicofacial Cellulitis Due to Dental Origin in the City of Ouagadougou (Burkina Faso)

Background: Head and neck cellulitis of dental origin are polymicrobial bacterial infections involving the cellulo-adipose spaces of the face and neck. The objective of this work was to describe the epidemiological and clinical profile of patients with head and neck cellulitis. Methods: This was a cross-sectional study conducted from 1 January to 30 June 2020. All patients consulting for cervico-facial cellulitis of dental origin in 2 university hospitals in Ouagadougou were included in the study. The usual parameters of descriptive statistics were estimated for each variable. Results: Two hundred and ninety-two cases (184 men and 108 women), aged 3 to 85 years were collected. The 25 - 35 years old were the most affected (33%). Decay was the leading dental cause (95.6%). The delay in consultation was included within 7 days in 74.66% of cases. Ninety-one-point forty-four percent of patients had poor oral hygiene. Diffuse cellulitis was the most common (64.04%) and peri-mandibular regions were the most invaded (42.81%). Conclusion: The frequencies observed in our study allow us to conclude that cervicofacial cellulitis of dental origin is still frequent and affects a young and disadvantaged population.

Bacteriological Profile and Antimicrobial Susceptibility Pattern of Cervico-Facial Cellulitis at the Regional Teaching Hospital of Ouahigouya (Burkina Faso)

Context and Objective: Cervicofacial cellulitis is a lethal infection without treatment. The aim of this study is to establish the bacteriological and antimicrobial susceptibility profile of cervico-facial cellulitis at the Regional Teaching Hospital (RTH) of Ouahigouya, in order to guide practitioners in the development of effective probabilistic antibiotic therapy protocols. Subjects and Methods: This was a transversal descriptive study with prospective data collection from July 1 to December 31, 2021 at the RTH of Ouahigouya. All cases of suppurative cervicofacial cellulitis that had been the subject of pyoculture were retained. Results: A total of 63 patients were chosen including 41 men, with 40.91 years as the average age and the sex ratio was 1.86. In 90.48% of cases, the front door was dental. All patients took antibiotics before their admission. Pus culture was positive in 34/63 subjects (53.97%) and showed monomicrobial infection. The isolates were Gram-negative bacilli for 20.59% and Gram-positive cocci for 79.41%. These isolates were all resistant to certain beta-lactams (such as amoxicillin, amoxicillin + clavulanic acid). However, some isolates were susceptible to cefoxitin, ceftazidime and ceftriaxone. All isolates were sensitive to amikacin for aminoglycosides. As for macrolides, erythromycin had excellent activity (100%) against Gram-positive cocci. Indeed, some isolates were susceptible and others resistant to ciprofloxacin for quinolones. Conclusion: Bacteriological profile and antimicrobial susceptibility knowledge of cervicofacial cellulitis may propose an effective probabilistic antibiotic therapy protocol.

Acute Orbitopathy Manifesting as Periorbital Cellulitis in Sickle Cell Disease

Sickle cell disease is a hemoglobinopathy that results in paroxysmal vascular occlusion and tissue infarction that can manifest in a plurality of tissues. Vasoocclusive crises in sickle cell disease commonly involve bone marrow of the long bones and vertebrae. Involvement of bones with less marrow space, including the bones of the orbit, is reported rarely in the literature and can closely mimic orbital cellulitis, both clinically and radiologically. The present case is a 3 years old boy, a known case of sickle cell disease, who presented with what was thought to be orbital cellulitis and was treated accordingly. Subtle radiologic features of sickle cell orbitopathy were initially overlooked, resulting in an incorrect diagnosis and a treatment delay for the patient. Correctly treated most cases resolve with no adverse effects. This case highlights the importance of maintaining a high index of suspicion in patients with known sickle cell disease, even when the presentation is not classic.

Diffuse Cervico-Facial Cellulitis: Epidemiological, Diagnostic and Therapeutic Aspects at the Teaching Hospital CNHU HKM of Cotonou

Purpose of the work: to study the epidemiological, clinical and therapeutic aspects of diffuse cervico-facial cellulitis collected within the ENT-CCF surgery department of the CNHU of Cotonou. Materials and method: the study was a descriptive retrospective carried out from January 1st, 2018 to December 31st, 2020. It concerned new cases of diffuse cervico-facial cellulitis identified during the period. Results: in 3 years, 55 cases of diffuse cervico-facial cellulitis were identified out of 1101 hospitalized patients. The frequency was 4.99%. Per year, 18 cases of cervico-facial cellulitis are recorded. The mean age of the patients was 41.3 years with extremes of 15 years and 85 years. A clear male predominance was noted with a sex ratio of 1.29. Painful cervico-facial swelling was the most common reason for medical consultation (47 patients or 85.5% of cases). Thirty patients (54.5%) showed a deterioration in general condition. Several clinical forms of diffuse cervico-facial cellulitis have been described, in particular the gangrenous form, the suppurative, necrotizing form and LUDWIG’s angina. The portal of entry was dental in 50 patients (91% of cases), favored by poor oral hygiene and self-medication with non-steroidal anti-inflammatory drugs (NSAIDs). The medico-surgical treatment implemented was favorable for 47 patients (85.5%). Conclusion: Diffuse cervico-facial cellulitis remains a frequent medical-surgical emergency in the CCF ENT department at the Teaching Hospital of Cotonou. Mainly of odontogenic origin, it is encountered in different clinical forms.

Head and Neck Cellulitis of Dental Origin and HIV Infection: 24 Cases

Cervico-facial cellulitis is a serious poly-microbial infection of the deep fascial spaces of the face and neck which may be life-threatening. The existence of an underlying ground that causes immune failure may promote or complicate this infection. The aim of this work was to describe the socio-demographic and clinical aspects of dental cervicofacial cellulitis associated with HIV in our context. It was a descriptive cross-sectional study that concerned all cases of cervico-facial cellulitis with positive HIV serology encountered at the CHU-CNOS of Bamako from May 2017 to January 2018. Twenty-four cases were collected. Cellulite with positive HIV accounted for 1.14% of consultations in the service. Females accounted for 67.66% of cases with a sex ratio of 0.5. The average age was 33.58 years old. Housewives accounted for 33.33% of cases. The bride and groom represented 83% of the cases. The triad (pain, swelling, and trismus) was the most common reason for consultation with 41.7% of cases. The tooth 37 was involved in 25% of the cases. In 87% of cases, patients were screened in the service. HIV-1 was found in 75.0% of cases. Complications such as peripheral facial palsy were found in three cases. The medico-surgical treatment was performed in 23 cases with a favorable evolution. The search for an underlying ground, in particular HIV infection, must be systematic in the face of diffuse cervicofacial cellulitis.

Diffuse Cervico-Facial Cellulitis: Epidemiological and Clinical Aspects of 297 Cases

Introduction: Cervicofacial cellulitis is a medical and surgical emergency, it is an extensive infection of the aponeurotic spaces of the face and neck. Although frequent in black Africa rather than in developed countries, they remain associated with a poor prognosis and few studies have been done on this subject. Their management must be early, probabilistic and then adapted to the bacteriological results of the pus taken. As Senegal is one of the many sub-Saharan African countries without recent data on cervicofacial cellulitis, we felt it was important to review the situation. The aim of our study was to describe the epidemiological and clinical aspects of cervicofacial cellulitis in the ENT department of Lamine Sine DIOP of the Fann National University Hospital of Dakar. Materials and Method: This was a retrospective study conducted over 5 years from January 2017 to December 2021 in the ENT-CCF LAMINE SINE DIOP Department of the CHNU FANN in Dakar. Our data sources were hospitalization registers and medical records of patients hospitalized for cervicofacial cellulitis. Our data were analyzed using the spss 12 for windows software. Results: During this 5-year period, we collected 297 cases of cervicofacial cellulitis, i.e. 19% of the hospitalizations. The average age was 35 years with a sex ratio of 2.23. The notion of taking NSAIDs was found in 90.57% of the cases, the immunocompromised background was present in 18 patients, i.e. 6.06% of the cases. The site of the swelling was sub-mento-maxillary in 49% of the cases and anterior cervical in 5% of cases. The portal of entry was dental in 189 patients, i.e. 64% of cases, and unknown in 3%. 4 deaths were recorded, i.e. 1.35% of patients hospitalized for cervicofacial cellulitis, and 1 case of mediastinitis with polyseritis was transferred to the Department of Thoracic and Cardiovascular Surgery, which had a favourable outcome. Conclusion: Cervicofacial cellulitis is a fairly common infection with a poor prognosis in developing countries. They affect a relatively young and healthy segment of the population. At the National University Hospital of Fann in Dakar, they are increasingly frequent and linked to the use of non-steroidal anti-inflammatory drugs.

Controlling cellulitis in broilers

1 DefinitionCellulitis is inflammation under the skin, inthe tissue between the skin and the underlyingmuscle. The cellulitis that is seen in broiler chick-ens at the processing plant is caused by a localizedbacterial infection, almost always Escherichia coli(E. coli or coliforms). The bacteria get under theskin through injuries (usually scratches from thetoe nails of other chickens). Because the infectionis localized and occurs most frequently under theskin of the posterior abdomen,it rarely causes ill-ness. It is difficult to see in live birds but is obvi-ous following scalding and defeathering.

Evaluation of hand infections in the emergency department using point-of-care ultrasound

BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.

Orbital inflammatory disease:Pictorial review and differential diagnosis

Orbital inflammatory disease(OID) represents a collec tion of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagno sis including infection, systemic inflammatory conditions and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cel lulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously though to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an importan role in elucidating any underlying etiology behind orbita inflammation and is critical for ruling out other condi tions prior to a definitive diagnosis of OID. In this re view, we will explore the common sites of involvemen by OID and discuss differential diagnosis by site and key imaging findings for each condition.

成人重症口底蜂窝织炎的治疗

重症口底蜂窝织炎系指发生于下颌下、舌下及颏下等多间隙的、广泛的急性蜂窝织炎。现将我科2000～2007年收治的21例成人重症口底蜂窝织炎治疗体会报道如下。

Study of Mortality and Causes of Death in the Service of Stomatology, Maxillofacial and Plastic Surgery of the Face at Cocody Teaching Hospital (RCI)

Introduction: The study of mortality is an indicator that allows a control and a review of the therapeutic measures in the hospital environment. The purpose of this work was to determine the epidemiological profile of the patients who died and analyse the circumstances of the death in a hospital service. Material and Methods: It is a retrospective descriptive study conducted in the service of Stomatology, maxillofacial and plastic surgery of the face over a period of 10 years (from January 1999 to December 2008). Seventy-two cases have been taken into account. Results: The crude death rate was 4.29%. Higher level of male has been noted with a sex ratio of 1.77. The most affected age groups were the 3rd and 2nd decades, respectively with 20.8% and 19.4% with an average age of 39 years. Cellulitis of the face and their complications were responsible for deaths in 58.33% of cases. The majority of deaths occurred between 6 p.m. and 6 a.m. (65.28%). These deaths were preventable in 5.6% of cases. Conclusion: Facing the lack of description of the ultimate circumstances of death in the medical records, the conclusion of this study has been the establishment of a regular medical audit in the service, which would track mortality in order to reduce its rate.