BACKGROUND AND OBJECTIVES: Clinical differentiation of peritonsillar abscess from peritonsillar cellulitis can be difficult and often relies on diagnostic needle aspiration that is invasive. The differential diagnosis of the two conditions is very important for the planning of treatment. This study is to evaluate the usefulness of gray scale image (GSI) and color doppler image (CDI) using intraoral ultrasonography in differential diagnosis of the peritonsillar abscess from peritonsillar cellulitis. MATERIALS AND METHODS: Twenty patients with suspected peritonsillar abscess were included in this study. GSI and CDI of the intraoral ultrasonography with 7-MHz curved linear array transducer were used. RESULTS: The peritonsillar abscess showed inhomogeneously hypoechoic or cystic space on GSI and rim-shaped color flow signal on CDI. The peritonsillar cellulitis showed homogeneously hypoechoic or striated textual appearance on GSI and diffusely increased color signal on CDI. The sensitivity of GSI for diagnosis of peritonsillar abscess and peritonsillar cellulitis was 91.7% and 77.8%, respectively, whereas the specificiy of CDI proved to be 100% for the diagnosis of both conditions. CONCLUSION: This study demonstrates that intraoral ultrasonography is a useful and noninvasive technique for diagnosis of peritonsillar abscess.
Cellulitis ; Diagnosis* ; Diagnosis, Differential ; Humans ; Needles ; Peritonsillar Abscess* ; Transducers ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.
Abscess ; Adult ; Cellulitis ; Child ; Diagnosis ; Diplopia ; Eye Movements ; Humans ; Necrosis ; Orbit* ; Orbital Cellulitis ; Prognosis ; Sinusitis* ; Sutures

PURPOSE: To report upon several cases of rhino-orbito-cerebral mucormycosis with variable clinical manifestations including ocular symptoms. METHODS: We documented three patients with rhino-orbital-cerebral mucormycosis and uncontrolled diabetes. RESULTS: The patients presented variable ophthalmic symptoms including blepharoptosis, ophthalmoplegia, visual disturbance, visual field defect and ocular pain. Despite administration of an antifungal agent within two days, all of the patients died. CONCLUSIONS: We reported the cases of three patients with rhino-orbito-cerebral mucormycosis presenting ophthalmic symptoms with a literature review. Variable initial symptoms were emphasized in making diagnosis of rhino-orbito-cerebral mucormycosis.
Blepharoptosis ; Diagnosis ; Humans ; Mucormycosis* ; Ophthalmoplegia ; Orbital Cellulitis ; Visual Fields

PURPOSE: The present study reviews the clinical features of orbital cellulitis in childhood for early diagnosis and proper treatment. METHODS: The authors performed a retrospective study by computed tomography (CT) on children under 14 years of age diagnosed with orbital cellulitis and admitted to Pusan National University Hospital from 2003 to 2010. RESULTS: In total, 27 patients were identified (range 4 months to 14 years). Periorbital swelling was the most common initiating symptom, followed by fever and conjunctival injection. Paranasal sinus disease was the most common predisposing factor. Preseptal cellulitis was the most common finding, followed by subperiosteal abscess, orbital cellulitis, and orbital abscess. All patients underwent a blood culture; none were positive. Intravenous antibiotics therapy was performed empirically and was effective in all cases. No patients suffered from permanent complications except recurrence. CONCLUSIONS: Orbital cellulitis in children presents with periorbital swelling, fever, conjunctival injection in association with sinusitis, and upper respiratory infection (URI). A CT study is a reliable diagnostic option for the early detection and localization in the pediatric orbital cellulitis. Early empirical antibiotic therapy is mandatory for successful treatment.
Abscess ; Anti-Bacterial Agents ; Cellulitis ; Child ; Early Diagnosis ; Fever ; Humans ; Orbit ; Orbital Cellulitis ; Paranasal Sinus Diseases ; Retrospective Studies ; Sinusitis

Adult ; Cellulitis ; diagnosis ; etiology ; Dyspnea ; diagnosis ; etiology ; Gas Gangrene ; complications ; diagnosis ; Humans ; Male

Necrotizing fasciitis, first described by Wilson in 1952, is one of the most dramatic infectious diseases which develops at the level of superficial fascia and involves the overlying dermis. Clinical diagnosis is often initially confused with cellulitis, and delay in the diagnosis and treatment is associated with high mortality in the range from 30% to 70%. Early diagnosis and prompt excision of all devitalized tissue are critical because any remaining necrotic tissue will continue the rapidly progressive infectious process. We, herein, report a 64-year-old man who was presented with a typical clinical course of necrotizing fasciitis.
Cellulitis ; Communicable Diseases ; Dermis ; Diagnosis ; Early Diagnosis ; Fasciitis, Necrotizing* ; Humans ; Middle Aged ; Mortality ; Subcutaneous Tissue

PURPOSE: A diagnosis of wooden intraorbital foreign bodies is common and their removal is often necessitated after complications become manifested. In case of operation, it is difficult to find and remove wooden foreign bodies completely. We have experienced a case of retained multiple intraorbital foreign bodies removed by the secondary operation. We report this case with a literature review. METHODS: A 39-year-old man visited our clinic complaining of diplopia, exophthalmos, and limitation of eyeball movement. He had fallen down and had a lacerated wound. Right after primary closure, he experienced strabismus, orbital cellulitis, and abscess. Several months later, he had a soft mass in the operated lower lid, and two wooden intraorbital foreign bodies were found. MRI detected granuloma and cellulitis near the cavernous sinus. RESULTS: More than ten intraorbital wooden foreign bodies were surgically removed. After the surgery exophthalmos and diplopia were improved, and limitation of eyeball movement disappeared. The MRI findings were also improved. CONCLUSIONS: Intraorbital wooden foreign bodies should be diagnosed with a thorough history taking and radiologic exam, due to a number of potential complications, such as orbital cellulitis, abscess, and diplopia. Furthermore, they should be removed in consideration that they can move spontaneously into the deep interior of the orbit.
Abscess ; Adult ; Cavernous Sinus ; Cellulitis ; Diagnosis ; Diplopia ; Exophthalmos ; Foreign Bodies* ; Granuloma ; Humans ; Magnetic Resonance Imaging ; Orbit ; Orbital Cellulitis ; Strabismus ; Wounds and Injuries

PURPOSE: To determine the usefulness of MR imaging for differentiation between infectious and non-infectiousbursitis. MATERIALS AND METHODS: MR images of 16 patients (18 lesions) in whom bursitis around the hip had beendiagnosed were analyzed for homogeneity of the bursa, the presence of septation, the enhancement pattern, andassociated findings. Clinical data (symptoms and signs, laboratory data, aspiration of the bursa, and surgicalfindings) were available for correlation. The location of bursitis was trochanteric (n=9), ischiogluteal (n=5),iliopsoas (n=3), or ischiotrochanteric (n=1). RESULTS: Etiologies included infection in seven cases (3 pyogenic; 4tuberculous) and noninfecti-on in 11 (6 inflammation; 3 hemorrhage; 2 metabolic disease). In seven patients withinfectious bursitis, T1-weighted enhanced image revealed thick rim enhancement of the bursa (n=7) association withchanges in bone marrow signal intensity (n=2), bone erosion (n=2), and cellulitis (n=1). Of 11 cases ofnoninfectious bursitis, three demonstrated typical signal characte-ristics of hematoma within the distended bursa.In six of seven patients who underwent contrast-enh ancement, thick and thin peripheral enhancement of the bursawas noted. Bone erosion was found in one case of tuberculous bursitis and two of metab-olic disease. Internalseptation (n=4) and internal debris (n=3) were found in both infected and noninfected patients. CONCLUSION: MRimaging plays an important role in the diagnosis of bursitis around the hip. MR findings of thick rim enhancement,associated cellulitis, and changes in bone marrow signal intensity are suggestive of infectious bursitis.
Bone Marrow ; Bursitis* ; Cellulitis ; Diagnosis ; Femur ; Hematoma ; Hemorrhage ; Hip* ; Humans ; Inflammation ; Magnetic Resonance Imaging

Recently another distinct subtype of lymphoma has been discovered, the natural killer (NK)T cell lymphoma, which can involve the skin in a primary or secondary fashion. NK/T cell lymphoma is characterized by the biphenotype expression of the T-cell marker and NK cell marker, especially CD56. These CD56+ lymphomas are further subdivided into nasal NK/T-cell lymphomas and non-nasal NK/T-cell lymphomas. We report a case of primary nasal NK/T cell lymphoma, which showed as an atypical cellulites-like lesion on the face. The patient had suffered with recurrent orbital swelling for several years before diagnosis.
Cellulitis* ; Diagnosis ; Humans ; Killer Cells, Natural ; Lymphoma* ; Orbit* ; Skin ; T-Lymphocytes

Wells' syndrome, also called eosinophilic cellulitis, is characterized by recurrent cutaneous swellings, which resemble acute bacterial cellulitis, distinctive histopathological changes, dermal eosinophilic infiltration and characteristic flame figure. A 53-year-old woman developed pruritic, erythematous, and edematous plaques on chest, abdomen, back and both upper arms. Histology of the plaques revealed a diffuse infiltration of eosinophils and flame figure in the dermis without granulomatous and vasculitic process, consistent with the diagnosis of Wells' syndrome.
Abdomen ; Arm ; Cellulitis ; Dermis ; Diagnosis ; Eosinophils ; Female ; Humans ; Middle Aged ; Thorax