Objective: To review the clinical characteristics, to illustrate diagnosis and management experience of orbital and cranial complications of pediatric acute rhinosinusitis. Methods: The clinical data of 24 children with orbital and cranial complications of acute rhinosinusitis who received endoscopic sinus surgery combined with drug treatment in Beijing Children's Hospital from January 2017 to December 2021 were retrospectively reviewed. There were 19 boys and 5 girls. The age varied from 13 to 159 months, with a median 47.5 months. The following diagnoses were obtained: 12 isolated subperiosteal orbital abscess, 2 associated with preseptal abscess, 2 associated with intraorbital abscess, 7 associated with optic neuritis, and 1 associated with septic cavernous sinus thrombosis. Clinical characteristics, organism isolated and outcomes were analyzed through descriptive methods. Results: All 24 patients presented with fever; 9 presented with nasal congestion and purulent discharge. The clinical manifestations of orbital infection included orbital edema, pain, proptosis and displacement of globe in all patients, while visual impairment was recognized in 7 children. Purulent drainage was cultured in 17 patients, among which 12 were positive. All patients underwent nasal endoscopic surgical interventions uneventfully, excluding one patient who required a second surgical procedure. Follow-up period ranged from 5 to 64 months. All patients resolved fully, with the exception of 2 children who got permanent blindness with visual loss preoperative. There was no recurrence or death. Conclusions: Orbital and cranial complications of pediatric acute rhinosinusitis could be severe with an occult onset. For patients with vison impairment, any signs of intracranial complications and a lack of response to conservative management, an urgent endoscopic intervention is needed.
Male ; Female ; Child ; Humans ; Abscess/therapy* ; Retrospective Studies ; Sinusitis/therapy* ; Orbital Cellulitis ; Acute Disease ; Exophthalmos ; Orbital Diseases/therapy*

Cellulitis ; Dermatitis ; Eosinophilia ; Humans ; Hypertrophy

This is a case of an 18-year-old Filipino female with no known comorbidities, who presented with a three-year history of recurrent erythematous papules, vesicles, and nodules over her bilateral side of the chin. She was initially managed as a case of infected acne vulgaris, and was given oral antibiotics such as Cloxacillin, Rifampicin, and Clarithromycin, but with minimal improvement. She was then referred to Dermatology service for further evaluation. A 3-mm skin punch biopsy on an erythematous nodule on the left chin was done, and histopathologic findings were diffuse eosinophilic infiltrates, exhibiting flame figures admixed with few lymphocytes and neutrophils, consistent with Wells’ syndrome, otherwise known as eosinophilic cellulitis. Serology also revealed elevated IgE level at 949.2 IU/mL but normal eosinophil count. Patient was then given oral corticosteroid for eight weeks, resulting in complete resolution of lesions and no residual scarring.
Wells syndrome ; Cellulitis ; Eosinophilia

We report a case of cellulitis caused by a novel Cupriavidus species identified using whole-genome sequence analysis. Subcutaneous tissue biopsies from the left lower leg of a 67-year-old man who suffered from cellulitis were cultured. Round, convex, gray and non-hemolytic colonies were recovered after 72-h incubation. 16S rRNA sequence analysis showed 98.6% similarity with Cupriavidus basilensis DSM 11853(T) in the NCBI database and 99.9% similarity with C. basilensis KF708 in the EzBioCloud database. Genomic analysis using the MiSeq platform (Illumina, USA) and the TrueBac ID database (ChunLab, Korea) revealed that the average nucleotide identity (ANI) of this strain with C. basilensis DSM 11853(T) was 87.6%. The patient was treated with oral cefditoren pivoxil for 9 weeks. This study is the first to report cellulitis caused by Cupriavidus species strain J1218.
Aged ; Biopsy ; Cellulitis ; Cupriavidus ; Genome ; Humans ; Leg ; Sequence Analysis ; Subcutaneous Tissue

cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found.CONCLUSION: The only method to increase the survival rate is to ‘suspect’ the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.]]>
Abdomen ; Allografts ; Amputation ; Burn Units ; Burns ; Cellulitis ; Communicable Diseases ; Debridement ; Electronic Health Records ; Fascia ; Fasciitis, Necrotizing ; Female ; Foot ; Fournier Gangrene ; Heart ; Hip ; Humans ; Hypertension ; Infection Control ; Injections, Intramuscular ; Inpatients ; Korea ; Leg ; Male ; Medical Records ; Methods ; Mortality ; Nutritional Support ; Sepsis ; Skin ; Stroke ; Survival Rate ; Toes ; Wounds and Injuries ; Wounds, Stab

BACKGROUND: Several studies have shown that people with diabetes are vulnerable to infection. This study compared the risk of infection-related hospitalizations, intensive care unit (ICU) admission, and deaths between the person with diabetes and the generalpopulation in South Korea.METHODS: We conducted a cohort study of 66,426 diabetes and 132,852 age-sex-region-matched non-diabetes controls from the general population using a sample of data from the National Health Insurance Service-National Sample Cohort. The cohort was followed up for 9 years. Infections were classified into 17 separate categories. We used Poisson regression, with adjustment for household income and other comorbidities, to estimate incidence rate ratios (IRRs) in order to compare of infection-related hospitalizations, ICU admissions, and deaths.RESULTS: Compared to non-diabetes controls, diabetes group had a greater risk of almost all the types of infections considered, with the adjusted IRRs (aIRRs) for infection-related hospitalizations being the highest for hepatic abscess (aIRR, 10.17; 95% confidence interval [CI], 7.04 to 14.67), central nervous system (CNS) infections (aIRR, 8.72; 95% CI, 6.64 to 11.45), and skin and soft tissue infections other than cellulitis (SSTIs) (aIRR, 3.52; 95% CI, 3.20 to 3.88). Diabetes group also had a greater risk of ICU admission and death due to SSTIs (aIRR, 11.75; 95% CI, 7.32 to 18.86), CNS infections (aIRR, 5.25; 95% CI, 3.53 to 7.79), and bone and joint infections (aIRR, 4.78; 95% CI, 3.09 to 7.39).CONCLUSION: In South Korea, people with diabetes has a considerably higher incidence of infection-related hospitalizations and deaths than the general population.
Cellulitis ; Central Nervous System ; Cohort Studies ; Comorbidity ; Diabetes Mellitus ; Family Characteristics ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Joints ; Korea ; Liver Abscess ; National Health Programs ; Skin ; Soft Tissue Infections

No abstract available.
Cellulitis* ; Klebsiella pneumoniae* ; Klebsiella* ; Leg*

Elephantiasis nostras verrucosa (ENV) is an uncommon condition caused by repeated inflammation and lymphatic obstruction. It occurs mainly in the lower extremities and is characterized by skin changes, including hyperkeratotic mossy papules and plaques, non-pitting edema, and cobblestone-like appearances. ENV can be diagnosed based on its typical clinical manifestations (pseudoepitheliomatous hyperplasia with enlarged lymphatic spaces, fibrous tissue proliferation, and chronic inflammation) and by skin biopsy. Although ENV is difficult to treat, reduction of lymphedema and use of keratolytic agents may be helpful. To our knowledge, only three cases of ENV have been reported. However, the case of ENV treated with oral acitretin has not been reported in domestic literatures. Therefore, we report the case of a 45-year-old woman who developed ENV. She had a past history of cellulitis and was successfully treated with oral acitretin.
Acitretin ; Biopsy ; Cellulitis ; Edema ; Elephantiasis ; Female ; Humans ; Hyperplasia ; Inflammation ; Keratolytic Agents ; Lower Extremity ; Lymphedema ; Middle Aged ; Skin

Cellulitis, one of most common diseases of everyday life, is often overlooked for its significance. Although cellulitis does not cause or lead to serious problems usually, its possibility to cause life-threatening problem should be known. In present case, a patient who had received acupuncture treatment a week earlier presented to the clinic with symptoms of facial cellulitis. The disease resolved within few weeks under empirical antibiotic treatment but recurred after 3 months. Under close history review of the patient, we found out that the patient had received craniectomy 20 years ago. The patient had blunt headache with no other neurological symptoms that could suspect cranial infection, but considering the risk originating from the patient’s surgical history, brain computed tomography (CT) was taken. CT images revealed abscess formation in the subgaleal and epidural spaces. Craniotomy with abscess evacuation was done promptly. With additional antibiotic treatment postoperatively, the disease resolved, and the 1-month postoperative follow-up brain CT showed no signs of abscess formation.
Abscess ; Acupuncture ; Brain ; Cellulitis ; Craniotomy ; Empyema ; Epidural Abscess ; Epidural Space ; Follow-Up Studies ; Headache ; Humans

BACKGROUND/AIMS: Cellulitis is a common infection in patients with liver cirrhosis. We aimed to compare risk factors, microbial aspects, and outcomes of cellulitis in compensated and decompensated hepatitis C virus (HCV)-related cirrhosis. METHODS: Six hundred twenty consecutive HCV-related cirrhotic patients were evaluated for cellulitis. Demographic and clinical data were evaluated, along with blood and skin cultures. Severity of cirrhosis was assessed using Child-Pugh score. In-hospital mortality was assessed. RESULTS: Seventy-seven (12.4%) cirrhotic patients had cellulitis (25 with compensated and 52 with decompensated disease). Smoking and venous insufficiency were risk factors of cellulitis in compensated cirrhosis. Leg edema, ascites, hyperbilrubinemia and hypoalbuminemia were risk factors in decompensated cirrhosis. Gram-positive bacteria (Staphylococcus spp. and Streptococcus pyogenes) were the infective organisms in compensated patients, while gram negative bacteria (Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) were the predominant organisms in decompensated cirrhosis. Fungi (Candida albicans and Aspergillus niger) were detected in 3 decompensated cases. In-hospital mortality in patients with cellulitis was 27.3%, approaching 100% in decompensated patients with gram-negative cellulitis. Prolonged hospitalization, higher model for end-stage liver disease (MELD)-Na score, septic shock, local complication, and recurrent cellulitis were predictors of mortality. CONCLUSIONS: Cellulitis in compensated cirrhosis is different from that of decompensated patients regarding microorganisms, pathogenesis, and prognosis. Cellulitis has a poor prognosis, with mortality rates approaching 100% in decompensated patients with gram-negative cellulitis. Stratifying patients according to severity of cirrhosis is important to identify the proper empirical antibiotic and to decide the proper means of care.
Ascites ; Aspergillus ; Cellulitis ; Edema ; Fibrosis ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hepacivirus ; Hepatitis C ; Hepatitis ; Hospital Mortality ; Hospitalization ; Humans ; Hypoalbuminemia ; Klebsiella pneumoniae ; Leg ; Liver Cirrhosis ; Liver Diseases ; Mortality ; Prognosis ; Pseudomonas ; Risk Factors ; Shock, Septic ; Skin ; Smoke ; Smoking ; Streptococcus ; Venous Insufficiency