Friday, August 15, 2008

In-Patient Preseptal Cellulitis: Experience from a Tertiary Eye Care Center.

In-Patient Preseptal Cellulitis: Experience from a Tertiary Eye Care Center.

Br J Ophthalmol. 2008 Aug

Chaudhry IA, Shamsi FA, Elzaridi E, Al-Rashed W, Al-Amri A, Arat YO.
King Khaled Eye Specialist Hospital, Saudi Arabia.

OBJECTIVE: To describe causes of preseptal cellulitis (PSC) and outcome of treatment in patients admitted to a tertiary eye-care center.

METHODS: A 15-year (January 1991 - December 2005) review of in-patients with clinical signs and symptoms or radiologic evidence suggestive of PSC was conducted. Patients with infection anterior to the orbital septum which is characterized by acute onset of eyelid edema, tenderness, erythema, warmth and chemosis were included in the study.

RESULTS: Among the 104 patients (Male:female 64:40) fulfilling the diagnostic criteria for PSC, acute dacryocystitis (ADC) was the most common predisposing cause in 32.6% patients, followed by sinusitis/upper respiratory infection (URI) in 28.8% and trauma/recent surgery in 27.8% patients. Fifty-percent required surgical intervention including dacryocystorhinostomy/probing/stenting in 74% and abscess/chalazian drainage in 28.8%. In 38.5% of the patients who had surgical intervention, microbiological investigations were carried out, cultures were positive in 90%. Most common microorganisms recovered included Staphylococcus and Streptococcus species followed by Haemophilus influenzae and Klebsiella pneumonia. Blood cultures were positive in 2 of the 34 patients in whom blood was drawn. Most patients responded to systemic antibiotics with resolution of PSC. Seven patients developed late complications which included subacute lid abscesses, eyelid necrosis and cicatricial ectropion.

CONCLUSIONS: Sinusitis/URI, ADC and recent history of trauma/ surgery were the most common cause of PSC in admitted patients. Although most patients responded to systemic antibiotics, surgical intervention was necessary in some patients to prevent associated complications.

PMID: 18697809 [PubMed - as supplied by publisher]


Tuesday, August 12, 2008

Escherichia coli Extensive Cellulitis After Laparoscopic Radical Prostatectomy.

Escherichia coli Extensive Cellulitis After Laparoscopic Radical Prostatectomy.
July 2008

El Karoui K, Lanternier F, Taieb F, Poirée S, Zahar JR, Mechaï F, Lortholary O, Peyromaure M.

Center of Infectiology Necker-Pasteur, Hôpital Necker Enfants-Malades, Paris, France; Departments of Infectious Diseases, Hôpital Necker Enfants-Malades, Paris, France.

A 59-year-old patient underwent laparoscopic radical prostatectomy (LRP) in our department. After surgery, he had an extensive cellulitis of the right flank develop. Urine, drainage effluent, and blood cultures were all positive for Escherichia coli. Prolonged broad spectrum antibiotherapy allowed progressive resolution of the cellulitis. This case shows that severe cellulitis can occur after LRP. Urinary tract infection and vesicourethral anastomotic leakage may contribute to this complication.



Monday, August 04, 2008

Histoplasmosis presenting as cellulitis 18 years after renal transplantation.

Histoplasmosis presenting as cellulitis 18 years after renal transplantation.
Med Mycol. 2008 Aug

Marques SA, Hozumi S, Camargo RM, Carvalho MF, Marques ME.
Department of Dermatology and Radiotherapy.

A 49-year-old renal transplant patient, under an 18-year course of immunosuppressive therapy with prednisone and azathioprine and, more recently, prednisone plus mycophenolate sodium, developed a cutaneous-subcutaneous infection caused by Histoplasma capsulatum. The clinical presentation consisted of a slowly enlarging, erythematous and infiltrative 25 cm plaque in the major axis on the arm. There was no involvement of the lungs or any other organ. Cure was obtained with itraconazole treatment after 12 months. Histoplasmosis is an uncommon opportunistic infection among solid organ transplanted patients with incidence of 0% to 2.1% observed in a large number of cases. This report describes an atypical cutaneous clinical presentation of a potentially fatal disease in immunosuppressed patients.