A case of unilateral periorbital cellulitis and mandibular osteomyelitis in a turkey flock.

Jun 2012

**Editor's opinion: The last two articles have discussed cellulitis infection in two birds that constitute a major portion of protein intake for people throughout the world. My thought is that perhaps if these birds were not crowded/packed into spaces that really don't even give them a space to turn around in, if the situation were more humane, clean and healthy, perhaps there would not be such a need for the massive antibiotics that are being given to to chickens and turkeys. In my humble layperson's opinion, there must be a correlation between the living conditions and the incident of infections and disease. Pat O'Connor**

Corrand L, Lucas MN, Douet JY, Etienne CL, Albaric AO, Cadec A, Guérin JL.

Source

Universite de Toulouse, INP, ENVT, 31076 Toulouse, France.

Abstract

A farm of meat turkeys was affected by a condition, clinically characterized by unilateral inflammation of the orbital region and progressive crossing of the beak, observed in three successive flocks in 2010. While no toxic, genetic, technical, or diet causes could be found, pathologic and bacteriologic analyses were conducted to investigate the case. Pathologic analyses of the heads of affected birds showed blepharitis and exudative sinusitis as well as severe chronic osteomyelitis of all skull bones and mandibula. Staphylococcus aureus was consistently isolated from these lesions. It is supposed that the severe bacterial osteomyelitis induced deviation of some bones, thereby leading to deviation of the beak. Further investigations remain to be carried out to explain these successive outbreaks of staphylococcal osteomyelitis in skull bones.

PubMed

Cellulitis lesions in broiler chickens are induced by Escherichia coli Vacuolating Factor (ECVF).

Nov 2012

Quel NG, Aragão AZ, Salvadori MR, Farias AS, Joazeiro PP, Santos LM, Sá LR, Ferreira AJ, Yano T.

Source

Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato, 255, Campinas, SP, CEP 13083-862, Brazil.

Abstract

Keywords

• APEC; 
• Avian cellulitis; 
• Escherichia coli Vacuolating Factor (ECVF); 
• Purification; 
• Cytokines; 
• Inflammatory response; 
• Dermatopathology

Escherichia coli Vacuolating Factor (ECVF) is a heat-labile, vacuolating cytotoxin produced by avian pathogenic E. coli (APEC) isolated from avian cellulitis lesions. In this report, we intend to demonstrate that purified ECVF induces the inflammatory process of cellulitis. Our group is the first to demonstrate the effect of ECVF in a histological analysis by in situ inoculation of broiler chickens with purified ECVF. The animals were inoculated with the APEC AC53 and with purified ECVF subcutaneously on their ventral surface (in the sternum region). The histological analysis showed different grades of an acute inflammatory response in the epidermis, dermis and panniculus. An increase in mRNA expression of the proinflammatory cytokine TNF-α was also demonstrated in the inflamed tissue. When ECVF was systemically administered, increased levels of TNF-α and IL-10 were observed in the serum. These results suggest that ECVF plays a key role in the inflammatory process associated with cellulitis that is mainly mediated by TNF-α. In addition, this inflammation can be down regulated by the anti-inflammatory. 

cytokine IL-10.

ScienceDirect

Arm Cellulitis images

Dermatlas



See extensive images on skin infections and conditions:

Skinsight



This image comes from an excellent site for information on lymphedema.  Cellulitis can result in damage to the lymphatics, thus triggering what is referred to as secondary lymphedema.

Lymphedema Therapy

see also:  Arm Lymphedema



MRSA Abscess and Surrounding Cellulitis in Right Arm of Patient


Washington.edu





Cellulitis

Genome Sequence of the Human-Pathogenetic Bacterium Vibrio vulnificus B2.

Dec 2012

Abstract

Vibrio vulnificus, which can lead to rapidly expanding cellulitis or septicemia, is present in the marine environment. Here, we present the draft genome sequence of strain B2, which was isolated from a septicemia patient in 2010.

Genome Announcement

Vibrio vulnificus is a human-opportunistic, Gram-negative pathogen, which is always present in marine environments and has been isolated from sediments, water, and many kinds of seafood, such as shrimp, fish, and oysters. This bacterium is highly lethal (>50%) and has been reported to be the leading cause of seafood-borne death in the United States (3). It has also been widely isolated from Chinese seafood markets (14). Infection with this bacterium can lead to rapidly expanding cellulitis or septicemia in predisposed individuals .......

Full Text Article

Journal of Bacteriology

Ludwig's Angina - An emergency: A case report with literature review.

Jul 2012

Candamourty R, Venkatachalam S, Babu MR, Kumar GS.

Source

Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Mahatma Gandhi Medical College and Research Institute Campus, Pillaiyarkuppam, Pondicherry, India.

Abstract

Keywords: Ludwig's angina, odontogenic infection, surgical decompression, tracheostomy

Ludwig's angina is a form of severe diffuse cellulitis that presents an acute onset and spreads rapidly, bilaterally affecting the submandibular, sublingual and submental spaces resulting in a state of emergency. Early diagnosis and immediate treatment planning could be a life-saving procedure. Here we report a case of wide spread odontogenic infection extending to the neck with elevation of the floor of the mouth obstructing the airway which resulted in breathlessness and stridor for which the patient was directed to maintain his airway by elective tracheostomy and subsequent drainage of the potentially involved spaces. Late stages of the disease should be addressed immediately and given special importance towards the maintenance of airway followed by surgical decompression under antibiotic coverage. The appropriate use of parenteral antibiotics, airway protection techniques, and formal surgical drainage of the infection remains the standard protocol of treatment in advanced cases of Ludwig's angina.

Full Text Article

NCBI-NLM

Preseptal cellulitis in a child caused by Megacopta centrosignatum

Dec 2012

Wong AC, Mak ST.

Source

Department of Ophthalmology, Union Hospital, Hong Kong. Electronic address: dralbertcmw@gmail.com.

Abstract

Preseptal cellulitis in children can be caused by a reaction to embedded insects, their body parts, or secretions. We report the case of a 2-year-old girl who presented with preseptal cellulitis caused by an insect identified as Megacopta centrosignatum in her superior fornix.

Link to full text Article

Elsevier Health

A case of community-acquired Acinetobacter junii-johnsonii cellulitis.

Jun 2012

Henao-Martínez AF, González-Fontal GR, Johnson S.

Source

Division of Infectious Diseases, University of Colorado, Denver, USA.

Abstract

Key words: Acinetobacter, cellulitis, community-acquired infections, bacteremia, blister, therapy.

Acinetobacter skin and soft tissue infection outside of the traumatic wound setting are rare occurrences. The majority of cases occur in the presence of significant comorbilities and by Acinetobacter baumanii. Herein a case is reported of community-onset, health-care-associated, non-traumatic cellulitis caused by Acinetobacter, species junii-johnsonii with bacteremia. This is the first reported case of Acinetobacter junii-johnsonii skin and soft tissue infection. Hemorrhagic bullae might be one of the clinical features of Acinetobacter cellulitis.

Case report 

In August 2010, a 48 year old man with a history of metastatic, stage IV, prostate cancer was admitted to the University of Colorado Hospital after being transferred from an outside hospital. The case was complicated by bladder obstruction, T8 fracture, spinal cord involvement and had been treated with androgen-deprivation therapy and local radiation therapy. The patient had been admitted one month prior to this presentation with a pulmonary embolus, methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia of unclear origin and also with a multidrug resistant (MDR) Serratia marcescens urinary tract infection. The patient recovered from that episode and was discharged to his home on intravenous (IV) ertapenem, 1gram every 24 hours. Several weeks later, the patient was readmitted to an outside hospital after developing a rapid progression of symptoms characterized by the following: marked fatigue, light headedness, fever, chills and right lower extremity swelling, erythema, tenderness and warmness. On admission the patient was found to be in septic shock, requiring intensive care unit care. He received aggressive fluid resuscitation therapy and pressor support; and he was placed empirically on IV vancomycin, piperacillin-tazobactam and levofloxacin. His hemodynamic parameters improved over the next two days, and he was transferred to our hospital with the documentation of a non fermenting gram negative rod (GNR) in blood culture (1 of 2 bottles). Computerized tomography (CT) scan of his leg showed a marked subcutaneous edema. The positive culture was from a peripheral site. The physical examination was remarkable for marked right lower extremity swelling, with erythema involving the distal 2/3 of the leg, and local tenderness, warmness and the presence of a purpuric rash and hemorrhagic bullae. The PICC line was present and was without local signs of inflammation. The laboratory tests were significant for leukopenia, anemia and thrombocytopenia. The gram negative rod was a nonmotile, catalase-positive, oxidase-negative bacteria; finally identified using the Vitek 2 system (an automated system for bacterial identification using a phenotypic approach) as Acinetobacter junii-johnsonii, sensitive to quinolones and B-lactams, and intermediate to aztreonam. His antibiotic therapy was narrowed to Levofloxacin only, and the patient was discharged 4 days later. He was seen again in the clinic 4 weeks later; complete resolution of his local right leg inflammatory changes were noted.

Full text with diagnostic images:

ScieLo

Campylobacter fetus infection presenting with bacteremia and cellulitis in a 72-year-old man with an implanted pacemaker: a case report.

Nov 2012

Ledina D, Ivic I, Karanovic J, Karanovic N, Kuzmicic N, Ledina D, Puljiz Z.

Abstract

INTRODUCTION: Campylobacter is an important causative agent of intestinal infections in humans. Bacteremia is detected in less than 1% of patients, mainly in immunocompromised patients and in extreme age groups. Cellulitis is a relatively common manifestation of Campylobacter infection, but concomitant bacteremia is a rare event. Infections of the pacemaker area are caused primarily by staphylococci, followed by fungi, streptococci and Gram-negative rods. To the best of our knowledge, this is the first case report of pacemaker pocket infection and bacteremia caused by Campylobacter fetus.

CASE PRESENTATION:

A 72-year-old Croatian Caucasian man with myelodysplasia, impaired fasting glucose levels and a recently implanted permanent pacemaker was admitted to hospital after six days of fever, development of red swelling of the pacemaker pocket area and worsening of his general condition. No antibiotic therapy was introduced in the outpatient setting. He denied any recent gastrointestinal disturbances. With the exception of an elevated leukocyte count, erythrocyte sedimentation rate, and C reactive protein and blood glucose levels, other laboratory findings were normal. Treatment with vancomycin plus netilmicin was introduced, and a surgical incision with drainage of the pacemaker pocket was performed. The entire pacemaker system was removed and a new one re-implanted after 14 days of antibiotic therapy. Transesophageal echocardiography showed no pathological findings. Three subsequent blood cultures obtained on admission as well as swab culture of the incised pacemaker area revealed Campylobacter fetus; stool and pacemaker lead cultures were negative. According to the microbiological results, antibiotic therapy was changed to ciprofloxacin plus netilmicin  A clinical examination and the results of a laboratory analysis performed after two weeks of therapy were within normal limits.

CONCLUSION:

Myelodysplasia, impaired fasting glucose levels and older age could be contributing factors for the development of bacteremic Campylobacter fetus cellulitis. Emergent surgical and antibiotic treatment are mandatory and provide the optimal outcome for such types of pacemaker pocket infection.

BioMed Central

Risk factors for abscess formation in patients with superficial cellulitis (erysipelas) of the leg.

Risk factors for abscess formation in patients with superficial cellulitis (erysipelas) of the leg.

Dec 2012

Picard D, Klein A, Grigioni S, Joly P.

Source

Department of Dermatology, Inserm U905, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University Hospital, University of Normandy, Rouen, France Nutrition unit and EA4311, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University Hospital, University of Normandy, Rouen, France.

Abstract

Background:  Superficial cellulitis of the leg (erysipelas) is a frequent skin infection. Abscess formation is the most frequent local complication. Determinants of abscess formation in patients with leg cellulitis have not been clearly established yet. 

The aim of this study was to assess risk factors for abscess formation in patients with leg cellulitis.

Patients and methods:  The clinical, biological and bacteriological records of all patients referred to the Dermatology Department of a University Hospital for superficial cellulitis of the leg during a 3-year period were retrospectively reviewed. Using univariate and multivariate analysis, main patients' characteristics at baseline were compared between the group of patients who developed abscess and the group who did not. 

Results:  One-hundred-and-sixty-four patients (93 females, 71 males) of mean age 65±18 years were included. Abscess occurred in 13 cases (8%). The following general factors were positively associated with abscess formation: male gender, smoking, alcohol abuse, delayed introduction of antibiotic treatment. Based on multivariate analysis, only chronic alcohol abuse (OR=4.3, 95%CI:1.08-20.57) and delayed antibiotic treatment initiation (OR=1.4, 95%CI:1.02-2.04) remained independently associated with abscess formation. 

Conclusion:  Alcohol abuse and delayed initiation of antibiotic treatment are risk factors for abscess formation in patients with cellulitis of the leg. Patients with these predictors must be monitored carefully for abscess formation.

Wiley

Leg Cellulitis Diagnostic Images

Leg Cellulitis Diagnostic Images