Methicillin-resistant Ascending Facial and Orbital Cellulitis in an Operation Iraqi Freedom Troop Population.

Methicillin-resistant Ascending Facial and Orbital Cellulitis in an Operation Iraqi Freedom Troop Population.
Ophthal Plast Reconstr Surg. 2007 Sep-Oct

Boden JH, Ainbinder DJ.
Department of Ophthalmology, Madigan Army Medical Center, Tacoma, Washington, U.S.A.

PURPOSE: To present a descriptive case series of methicillin-resistant ascending facial and orbital cellulitis in an Operation Iraqi Freedom troop population.

METHODS: A physician's transfer records of patients cared for and or transferred from the 31st and 86th Combat Support Hospitals during Operation Iraqi Freedom between September 2004 and March 2005 were reviewed. Cases of facial and orbital cellulitis caused by a nasal mucosal source were included in the case series.

RESULTS: Five cases of ascending facial and/or orbital cellulitis caused by an aggressive nasal source are reported. All nasal microabscess cultures demonstrated methicillin-resistant Staphylococcus aureus species. None of the patients complained of nasal pain as the chief complaint, and all patients overlooked the follicular abscess at or inside the nares.

CONCLUSIONS: Occult nasal infections with methicillin-resistant Staphylococcus aureus can be the source of an aggressive ascending facial and orbital cellulitis. The nasal source can be overlooked because of the distracting presentation of the orbital and systemic findings. With the increasing prevalence of community-acquired methicillin-resistant Staphylococcus aureus infections, a nasal examination and nasal culture can greatly assist in the diagnosis and management of patients presenting with orbital cellulitis without a clear source of infection.

Lippincott, Williams & Wilkins

The design, characteristics and predictors of mortality in the North of England Cellulitis Treatment Assessment (NECTA).

The design, characteristics and predictors of mortality in the North of England Cellulitis Treatment Assessment (NECTA).

Int J Clin Pract. 2007 Aug 31
Tan R, Newberry DJ, Arts GJ, Onwuamaegbu ME.

Meto E. Onwuamaegbu,Experimental Medicine,Hammersmith Hospital,Du Cane Road, London W12 0TE, UKTel.: + 44 208 383 1000Email: drmeto@doctors.net.uk

Department of Medicine for the Elderly, Addenbrookes Hospital, Cambridge, UK.

Aims: Cellulitis is a common cause of acute medical admissions in UK hospitals. The factors that determine susceptibility to an acute admission or to mortality following hospital admission are poorly defined.

Methods: We studied a retrospective cohort of 568 patients with a diagnosis of cellulitis between 1 January 2001 and 31 December 2003 in the north-east of England to see whether we could determine these factors. We collected data on the factors that were associated with acute hospital admissions and survival. We used a primary end-point of deaths within 1 year of admission for cellulitis.

Results: The characteristics that identified patients at high risk of mortality were present in 39.9% of the cohort studied.

The four most common of these characteristics were lower limb oedema 30.1% (95% CI: -26.0 to 34.1), ulceration 24% (95% CI: -20.2 to 27.8), previous myocardial infarction (MI) 19.9% (95% CI: -16.3 to 23.4) and blunt injury 18.7% (95% CI: -15.3 to 22.2). Significant predictors of mortality were: patient's age (p < p =" 0.003)," p =" 0.01)">

Treatment with i.v. flucloxacillin was found to be a significant predictor of survival (odds ratio = 3.43, z =3.42. p <>

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