Unrecognized bladder perforation leading to severe progressive cellulitis and candidal infection.

Mar Apr 2012

Fenderson JL, Washington BB, Hampton BS, Myers D.

Source

Department of Obstetrics and Gynecology, Women & Infants' Hospital of Rhode Island, Providence, RI, USA. jfenderson@wihri.org

Abstract

BACKGROUND:

Retropubic midurethral slings are a minimally invasive surgical procedure used in the treatment of stress urinary incontinence and are typically associated with high cure rates and low complication rates. Bladder perforation is a known intraoperative complication that, if left unrecognized, can have significant morbidity.

CASE:

A 47-year-old underwent a retropubic midurethral sling, anterior colporrhaphy, and cystoscopy. She developed a suprapubic wound cellulitis that progressed to involve the right trunk and flank as well as persistent fever for more than 48 hours despite broad-spectrum antibiotics. Upon return to the operating room, the patient was found to have an unrecognized bladder perforation with mesh in the bladder. Wound culture was remarkable for Candida parapsilosis and Escherichia coli.

CONCLUSION:

Unrecognized bladder perforation and nonbacterial causes of infection should be considered in patients with severe progressing cellulitis despite broad-spectrum antibiotic coverage after retropubic midurethral sling placement.

Wolters Kluwer

Life-threatening Escherichia coli cellulitis in patients with haematological malignancies.

Sept 2012

Sunder S, Haguenoer E, Bouvet D, Lissandre S, Bree A, Perrotin D, Helloin E, Lanotte P, Schouler C, Guillon A.

Source

1Service de Médecine Interne et Maladies Infectieuses, CHRU de Tours, France.

Abstract

Cellulitis due to Escherichia coli is rare and usually secondary to a cutaneous portal of entry. Skin and soft tissue infections (SSTI) secondary to E. coli bacteraemia have been reported exclusively in immunodeficient patients. Here, we report two cases of serious cellulitis secondary to E. coli bacteraemia in patients with haematological malignancies. Both isolated strains belonged to phylogenetic group B2 and harboured some of the main virulence factor genes commonly found in extra-intestinal pathogenic E. coli (ExPEC), including neuC, iro and fimH. Cellulitis due to E. coli seems to be linked to the immunocompromised status of patients rather than to a highly virulent clone. Nevertheless, some of the virulence factors appear to be important because both isolates belong to phylogenetic group B2. This aetiology should be considered in SSTI in patients with haematological malignancies.

Full Text Article

Journal of Medical Microbiology

Spontaneous Escherichia coli cellulitis in a child with nephrotic syndrome.

Spontaneous Escherichia coli cellulitis in a child with nephrotic syndrome.

Pediatr Infect Dis J. 2007 Mar

Sleiman JN,
D'Angelo A,
Hammerschlag MR.
Department of Pediatrics, Division of Infectious Diseases, Box 49, State University of New York Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA. joseph.sleiman@downstate.edu

Spontaneous bacterial peritonitis is the most common infectious complication of childhood nephrotic syndrome, and Streptococcus pneumoniae is the preponderant bacterial pathogen. Spontaneous bacterial cellulitis, especially of the lower extremities, is another common infection encountered in the same patient group given that chronic edema acts as a potential culture medium. Gram-positive bacteria, including streptococci and staphylococci, are the most common causes of bacterial cellulitis. We report a case of spontaneous Escherichia coli cellulitis in a patient with steroid-dependent nephrotic syndrome.

PMID: 17484229 [PubMed - in process]