Role of Bacteria in Dermatological Infections
K. Balamurugan, U. Prithika in Pocket Guide to Bacterial Infections, 2019
Frequently witnessed facial cellulitis is now a rarely observed type, which is recently demarcated as erysipelas (superficial cellulitis) in some literature. The vital complication associated with facial cellulitis comprises odontogenic or orbital infections, which require immediate attention and surgical episodes (Stevens et al., 2014). Perianal cellulitis is witnessed in young children and is characterized by purulent drainage, perianal pruritus, fissures, and rectal bleeding. Periorbital cellulitis is observed in eyelid portion and periorbital tissues. Buccal cellulitis is greatly observed in children before vaccination with conjugated H. influenzae type b vaccine and is responsible for 25% of the facial cellulitis cases (Swartz, 2004). Purulent cellulitis may also be observed in several cases, which occur as an extension of initial abscess and culminate in secondary cellulitis followed by purulent drainage and exudation (Ibrahim et al., 2015).
Paediatric Imaging
Gareth Lewis, Hiten Patel, Sachin Modi, Shahid Hussain in On Call Radiology, 2015
The findings of periorbital cellulitis on CT imaging include periorbital soft tissue swelling and inflammatory fat stranding, which are both limited to the pre-septal soft tissues (Figure 4.11). Orbital cellulitis may demonstrate similar findings to periorbital cellulitis, but with post-septal involvement. Post-septal involvement may be indicated by an intraconal or extraconal soft tissue mass (which may or may not demonstrate post-IV contrast enhancement), stranding of the intraconal fat and thickening of the intraorbital musculature (Figures 4.12a, b). The intraorbital structures and intraconal fat are best visualised on appropriate image window settings (width 400, level 40). Post-contrast images should be reviewed in order to identify any enhancing subperiosteal collections that may require surgical drainage (Figures 4.13a, b). The orbit should be inspected in all three planes using multiplanar reformats; subperiosteal collections are often best visualised in the coronal plane.
Emergency management of the complications of infective sinusitis
S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague in ENT Head & Neck Emergencies, 2018
Periorbital cellulitis is a term used to encompass all infections within the orbit. The orbital septum is a fibrous sheet that effectively acts as a barrier to spread of infection, and infections are therefore categorised as pre-septal or post-septal. Infections included in the global term of periorbital cellulitis include pre-septal cellulitis, post-septal cellulitis, subperiosteal abscess and orbital abscess. Spread of infection into the orbit is either from the ethmoid or frontal sinuses, according to age, development and anatomy of the frontal sinus. Infection is often preceded by an upper respiratory infection, but underlying frontal or ethmoid sinus pathology may occasionally predispose to infection, especially in adults.
Orbital ecthyma gangrenosum in multiple myeloma
Published in Baylor University Medical Center Proceedings, 2019
Binoy Yohannan, Mark Feldman
A 58-year-old man presented with 2 days of painless left periorbital swelling that rapidly progressed to a black eschar. He also had blurry vision in his left eye and a large ecchymotic patch over his scalp. He had known multiple myeloma refractory to therapy despite two autologous stem cell transplants. One week earlier, he had started a new regimen consisting of dexamethasone, cyclophosphamide, etoposide, and cisplatin. He was also known to have heart failure and atrial fibrillation, for which he was taking rivaroxaban. On admission his temperature was 38.3°C, his heart rate was 120 beats a minute, and his blood pressure was 80/60 mm Hg. The left eye lid was markedly swollen with bluish-black discoloration, and he was unable to open it (Figure 1a). His vision was intact, but the visual field was obscured by the swelling. A large ecchymosis was noted over the scalp with skin breakdown and mild oozing (Figure 1b). He also had a 2 × 3-cm ecchymotic patch beneath his left nipple (Figure 1c). Laboratory studies are shown in Table 1. Computed tomography of the orbit showed diffuse left periorbital cellulitis without any fluid collection. Chest x-ray was normal.
Subgaleal haematoma as a cause of periorbital necrotising fasciitis: a case report
Published in Orbit, 2020
Chloe FT Ting, Jonathan Lam, Con Anastas
A 35-year-old female initially presented to a peripheral hospital having developed bilateral periorbital pain and swelling that increased over a one-day period. This was associated with an unwitnessed fall 3 days prior to her presentation where she sustained a laceration to the occiput after hitting her head against the edge of a window with no other complaints. There was a background history of chronic alcohol abuse. A presumptive diagnosis of bilateral periorbital cellulitis was made and IV flucloxacillin was commenced. In the subsequent 14 hours the swelling and pain increased. She also began to demonstrate signs of sepsis including fever, hypotension and tachycardia. At that point, preliminary blood cultures were suspicious of a Streptococcal infection. IV clindamycin was added to her therapeutic regimen and she was transferred to Royal Perth Hospital for further management.
Aetiology and clinical features of facial cellulitis: a prospective study
Published in Infectious Diseases, 2018
Eivind Rath, Steinar Skrede, Haima Mylvaganam, Trond Bruun
The median duration of symptoms prior to admission was two days, with 37% (24/65) having symptoms for at least three days. The majority of cases had typical erysipelas signs with sharply demarcated erythema and raised borders (Table 2). There were no cases with orbital cellulitis or infection of dental origin in this study. However, in several cases, the lesion affected the periorbital area, but only one case had isolated periorbital cellulitis. Fifty-four percent (35/65) had infections originating in the middle third of the face.