MCANISMES MOLCULAIRES IMPLIQUS DANS L'ALTRATION DU PHNOTYPE DES CELLULES PITHLIALES TUBULAIRES PAR LES CALPANES EXTRACELLULAIRES

Objectif Rechercher les mecanismes moleculaires par lesquels des calpaines extracellulaires affectent l＇adherence et la mobilite des cellules epitheliales HK-2 derivees du tubule proximal humain. Mdthodes Western blot pour detecter le clivage des chaines α des integrines; dosage radioimraunologique pour mesurer V AMP cyclique intraceUulaire; fluorescence-activated cell sorting （FACS） pour tester l＇apoptose cellulaire. La morpholo- gie des ceUules HK-2 a ete observee et photographiee. Rdsultats （ 1 ） L ＇ exposition des ceUules HK-2 a la calpaine μ n＇a pas entratne de clivage des chaines α3 et αV des integrines; （2）V exposition des cellules HK-2 -2 la calpaine μ entrafnait une augmentation progressive de V accumulation intraceUulaire d＇ AMP cyclique（ P 〈 O. 05） qui etait associee une resistance ceUulaire a Vapoptose（ P 〈 O. 05 ） ; （3）Vaddition d＇un inhibiteur pharmacologique de la protdine kinase A （ PKA ） prevenait totalement les modifications d＇ adherence et de mobilite cellulaires induites par calpaine μ. Conclusion Les calpaines externalieses peuvent modifier V adherence et la mobilite ceUulaires via un mecanisme qui implique V accumulation d＇ AMP cyclique et 1＇ activation de la PKA. Par ces mecanismes, les calpaYnes externalisees pourraient jouer un role dans Vinduction de la reparation au cours de l＇insuffucance renale aigue.

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.

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.

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.

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.

Fascial space odontogenic infections: Ultrasonography as an alternative to magnetic resonance imaging

BACKGROUND The introduction of modern diagnostic tools has transformed the field of maxillofacial radiology.Odontogenic infection and fascial space involvement have been evaluated with many diagnostic tools,including ultrasonography(USG)and magnetic resonance imaging(MRI).AIM To explore USG as an alternative model to MRI in the detection of fascial space spread of odontogenic infections.METHODS Among 20 patients,50 fascial spaces were clinically diagnosed with odontogenic infection and included in this prospective study.Fascial space infection involvement was examined by USG and MRI.Results were compared for both and confirmed by microbiological testing.RESULTS Ultrasonography identified 42(84%)of 50 involved fascial spaces.Whereas MRI identified all 50(100%).USG could stage the infections from edematous change to cellulitis to complete abscess formation.CONCLUSION MRI was superior in recognizing deep fascial space infections compared to USG.However, USG is a significant addition and has a definite role in prognosticatingthe stage of infection and exact anatomic location in superficial space infections.

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.

超声引导下经皮穿刺单点置管引流及两点置管对冲引流治疗头颈部蜂窝织炎的比较

目的 比较头颈部蜂窝织炎患者行超声引导下经皮穿刺单点置管引流及两点置管对冲引流的疗效。方法 2019年1月~2023年4月在南京医科大学附属南京医院行超声引导下置管引流的颈部蜂窝织炎患者36例,经皮穿刺放置一次性穿刺套管针,外接引流袋负压引流。患者随机分为A、B两组,A组患者行单点置管引流,B组患者行两点置管对冲引流。结果A组患者平均置管时间(10.04±3.22)d,B组患者平均置管时间(9.82±4.20)d,差异无统计学意义(P>0.05)。36例患者在1个月内均治愈,未出现明显并发症,且随访半年无复发。A、B两组患者年龄、脓肿大小及置管时间差异无统计学意义(P>0.05),脓肿大小与置管时间之间存在相关关系(r_(s)=0.803,P <0.001)。结论 超声引导下经皮穿刺单点置管引流与两点置管对冲引流治疗头颈部蜂窝织炎疗效相当,且费用更低,值得在临床推广应用。

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.

Fatal thrombotic complications of hepatic cystic compression of the inferior vena: A case report

Of 5% of patients who develop liver cysts, only 10-15%of them come for medical attention, typically because of dull right upper quadrant pain, abdominal bloating or early satiety. We treated a 77-year-old female with a rare complication of inferior vena cava thrombosis. The patient expired due to septic shock and multiple organ failure.

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.

Natural killer/T-cell lymphoma with intracranial infiltration and Epstein-Barr virus infection: A case report

BACKGROUND Because of atypical clinical symptoms,lymphoma is easily confused with infectious diseases.Extranodal nasal-type natural killer/T-cell lymphoma(NKTL)is more common,and there are few cases of eyelid site onset and intracranial infiltration,which increases the difficulty of diagnosis.This disease usually has a very poor prognosis and there are few reports of recovery.CASE SUMMARY A 3-year-old boy was admitted to our hospital due to an initial misdiagnosis of"eyelid cellulitis"and failed antibiotic treatment.He was characterized by fever,right eyeball bulging,convulsions,and abnormal liver function.His blood Epstein-Barr virus(EBV)DNA was positive(8.798×10^4 copies/mL),and remained positive for about half a year.The cranial imaging examination suggested a space-occupying lesion in the right eyelid,with the right temporal lobe and meninges involved.The boy underwent ocular mass resection.The pathological diagnosis was NKTL.He was diagnosed as having NKTL with intracranial infiltration,combined with chronic active EBV infection(CAEBV).Then he underwent systemic chemotherapy and intrathecal injection.The boy suffered from abnormal blood coagulation,oral mucositis,diarrhea,liver damage,and severe bone marrow suppression but survived.Finally,the tumor was completely relieved and his blood EBV-DNA level turned negative.The current follow-up has been more than 2 years and his condition is stable.CONCLUSION This case suggests that chemotherapy combined with intrathecal injection may have a good effect on intracranial infiltrating lymphoma and CAEBV,which deserves further study and discussion.

Pregnancy and Oral Pathology

Introduction: Dental pathologies during pregnancy can compromise the prognosis of pregnancy and that of the mother. We report a first-study of cases of association of pregnancy and oral pathology supported in the Department of Odonto-stomatology of the National Hospital of Niamey. Objective: To report epidemiology, treatment and prognosis of dental origin cervicofacial cellulitis associated with pregnancy. Patients and Methods: This is a retrospective and prospective study over 5 years from August 1st, 2013 to July 31, 2018 involving 21 pregnant women in the Odonto-stomatology Department of the National Hospital of Niamey (HNN). Results: During the study period, 585 patients were consulted in the Odonto-stomatology Department for cervicofacial tooth cellulitis of dental origin, 21 of them were pregnant women (3.39%). The average age of the pregnant patients was 29.57 years old, extrems 25 - 29 years old. The average delay before consultation was 28.76 days. Majority patients were rural inhabitants The pathology happened in the third trimester of pregnancy (52.39%), second trimester (33.33%), in first (14.29%). This pathology was observed among disadvantaged socioeconomic class as housewives (85.71%) and uneducated women (61.90%). The lake of oral hygien was the main cause of cellulitis. We noted a history of periodontal disease (52.38%), fever upper 38°C (61.90%), trismus (85.71%,) dysphonia (42.86%), odynophagia (23.81%), dysphagia (42.86%), dyspnea (33.33%), and cervicofacial swelling (100%.) The treatment was medico-surgical. The prognosis depended on the precocious treatment with 76.19% cured. But unfortunately 4 cases died (19.05%), still for birth (52.38%) and 9.52% abortion. Conclusion: Association dental origin cervicofacial

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.