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The Netherlands Journal of Medicine Nov 2017Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired.... (Review)
Review
Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired. Diabetes, obesity and old age are associated with defects in all of these areas and as a result are major predisposing factors for cellulitis. In this review, we summarise current insights into the pathophysiology of cellulitis and place the Dutch guidelines on the clinical management of cellulitis of the lower extremities in perspective. Recent evidence on diagnostic strategies is discussed, the importance of which is underscored by findings that venous insufficiency, eczema, deep vein thrombosis and gout are frequently mistaken for cellulitis. Empiric antibiotic choices are designed against the background of a low prevalence of multi-resistant Staphylococcus aureus. Novel antimicrobial agents registered for cellulitis are also discussed. Relapses occur frequently due to a high prevalence of risk factors associated with cellulitis in combination with the ccurrence of persistent post-inflammatory lymphatic damage. Lastly, we identify knowledge gaps which, if addressed, will advance our understanding of the pathophysiology of cellulitis and improve its clinical management.
Topics: Anti-Bacterial Agents; Cellulitis; Hospitalization; Humans; Recurrence; Risk Factors
PubMed: 29219814
DOI: No ID Found -
Cleveland Clinic Journal of Medicine Aug 2012Distinguishing true cellulitis from its many imitators is challenging but critical if we are to avoid unnecessary use of antibiotics and delays in treatment. Common... (Review)
Review
Distinguishing true cellulitis from its many imitators is challenging but critical if we are to avoid unnecessary use of antibiotics and delays in treatment. Common imitators of cellulitis are stasis dermatitis, lipodermatosclerosis, contact dermatitis, lymphedema, eosinophilic cellulitis, and papular urticaria. Specific criteria do not exist for the diagnosis of cellulitis, but the alert physician can find clues in the history and physical examination that point toward cellulitis.
Topics: Cellulitis; Dermatitis; Diagnosis, Differential; Humans; Lymphedema; Urticaria
PubMed: 22854433
DOI: 10.3949/ccjm.79a.11121 -
Clinical Medicine (London, England) Mar 2018Cellulitis is a frequently encountered condition, but remains a challenging clinical entity. Under and overtreatment with antimicrobials frequently occurs and mimics...
Cellulitis is a frequently encountered condition, but remains a challenging clinical entity. Under and overtreatment with antimicrobials frequently occurs and mimics cloud the diagnosis. Typical presentation, microbiology and management approaches are discussed.
Topics: Anti-Infective Agents; Antibiotic Prophylaxis; Cellulitis; Diagnosis, Differential; Humans; Risk Factors
PubMed: 29626022
DOI: 10.7861/clinmedicine.18-2-160 -
Acta Medica Portuguesa Mar 2021Non-necrotizing acute dermo-hypodermal infections are infectious processes that include erysipela and infectious cellulitis, and are mainly caused by group A... (Review)
Review
Non-necrotizing acute dermo-hypodermal infections are infectious processes that include erysipela and infectious cellulitis, and are mainly caused by group A β-haemolytic streptococcus. The lower limbs are affected in more than 80% of cases and the risk factors are disruption of cutaneous barrier, lymphoedema and obesity. Diagnosis is clinical and in a typical setting we observe an acute inflammatory plaque with fever, lymphangitis, adenopathy and leucocytosis. Bacteriology is usually not helpful because of low sensitivity or delayed positivity. In case of atypical presentations, erysipela must be distinguished from necrotizing fasciitis and acute vein thrombosis. Flucloxacillin and cefradine remain the first line of treatment. Recurrence is the main complication, so correct treatment of the risk factors is crucial.
Topics: Anti-Bacterial Agents; Cellulitis; Cephradine; Erysipelas; Floxacillin; Humans; Recurrence; Soft Tissue Infections
PubMed: 33971117
DOI: 10.20344/amp.12642 -
Medicina Oral, Patologia Oral Y Cirugia... 2004Of all infections associated to oral pathology, the most relevant ones are those that are related to dental pathology. Cellulitis is an infection of the cellular adipose...
Of all infections associated to oral pathology, the most relevant ones are those that are related to dental pathology. Cellulitis is an infection of the cellular adipose tissue located in the aponeurotic spaces. It can be classified on the basis of location, severity and evolution. The aponeurotic compartments that allow odontogenic infections to spread have been categorised as: superficial compartment, floor of the mouth, masticator compartment, parapharyngeal space, parotid space and paratonsillar space. The present work describes the anatomical structures that comprise these spaces. The clinical forms of facial cellulitis are divided into acute and chronic. Potential complications consist of orbital infections, necrotising fascitis, thrombosis of the cavernous sinus, cerebral abscess and mediastinitis. Diagnosis is made on the basis of anamnesis, physical examination and complementary procedures (analytical tests and imaging studies). Treatment includes: treatment of causes (depending on the underlying cause in each case), incision and drainage, antibiotic therapy (chosen empirically) and complementary medical care. Odontogenic infections are primarily treated with surgery and coadjuvant antibiotic therapy.
Topics: Anti-Bacterial Agents; Cellulitis; Drainage; Face; Focal Infection, Dental; Humans; Mouth Diseases; Neck
PubMed: 15580131
DOI: No ID Found -
The Western Journal of Emergency... Mar 2019Septic arthritis is a dangerous medical condition associated with significant morbidity and mortality. However, the differential diagnosis can be broad with conditions... (Review)
Review
Septic arthritis is a dangerous medical condition associated with significant morbidity and mortality. However, the differential diagnosis can be broad with conditions that mimic this disease and require different evaluation and treatment. This narrative review presents the emergency medicine evaluation and management, as well as important medical conditions that may mimic this disease. Septic arthritis commonly presents with monoarticular joint pain with erythema, warmth, swelling, and pain on palpation and movement. Fever is present in many patients, though most are low grade. Blood testing and imaging may assist with the diagnosis, but the gold standard is joint aspiration. Management includes intravenous antibiotics and orthopedic surgery consult for operative management vs. serial aspirations. Clinicians should consider mimics, such as abscess, avascular necrosis, cellulitis, crystal-induced arthropathies, Lyme disease, malignancy, osteomyelitis, reactive arthritis, rheumatoid arthritis, and transient synovitis. While monoarticular arthritis can be due to septic arthritis, other medical and surgical conditions present similarly and require different management. It is essential for the emergency clinician to be aware how to diagnose and treat these mimics.
Topics: Anti-Bacterial Agents; Arthritis, Infectious; Cellulitis; Diagnosis, Differential; Edema; Emergency Service, Hospital; Emergency Treatment; Erythema; Fever; Humans; Pain
PubMed: 30881554
DOI: 10.5811/westjem.2018.10.40974 -
Archivos Argentinos de Pediatria Aug 2018An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria). It comprises various clinical conditions, whose importance varies... (Review)
Review
An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria). It comprises various clinical conditions, whose importance varies depending on their frequency and potential severity. It is the most common type of oral infection and its treatment involves up to 10% of all antibiotic prescriptions. Facial cellulitis is a diffuse inflammation of soft tissue that is not confined or limited to a specific region and tends to spread. The objective of this review is to update the aspects considered in the care of children with facial cellulitis of odontogenic origin and the multidisciplinary management between dentists and pediatricians.
Topics: Anti-Bacterial Agents; Bacterial Infections; Cellulitis; Child; Dentists; Face; Focal Infection, Dental; Humans; Pediatricians
PubMed: 30016031
DOI: 10.5546/aap.2018.eng.e548 -
Romanian Journal of Ophthalmology 2020This study aimed to determine the most frequent clinical aspects in patients with odontogenic orbital inflammation, the computed tomography (CT) aspect, and the most...
This study aimed to determine the most frequent clinical aspects in patients with odontogenic orbital inflammation, the computed tomography (CT) aspect, and the most appropriate treatment. This is a retrospective case-series study conducted on 3 patients with ages between 16 and 55 years old, in the Ophthalmology and Oro-Maxillo-Facial Clinics of "Sf. Spiridon" Emergency Hospital, Iași, Romania. The following investigations were performed in all selected cases: visual acuity (VA), ocular motility examination, anterior segment examination at slit-lamp, fundus examination, intraoral clinical examination, sinus and orbital involvement on CT scan, pathogens involved. All three patients presented swelling of the genic and periorbital regions, conjunctival chemosis, hyperemia of the conjunctiva, proptosis, pain, decreased vision and extraocular movement restriction. The CT examination identified orbital and periorbital cellulitis and ethmoidal expanded maxillary sinusitis or pansinusitis. Dental extraction, transalveolar drainage and orbital decompression were performed in all three cases. The evolution was favorable with remission of proptosis, edema of the genic and periorbital regions and conjunctival chemosis. Visual acuity remained poor in one case due to total optic nerve atrophy. Our study had a small number of patients, but the data was pertinent to ophthalmologists and maxillofacial surgeons who need to be aware of typical clinical features and the most common etiologies. Late treatment of dental infections can lead to severe ocular manifestations such as orbital cellulitis. Odontogenic orbital inflammation management involves a long-term and multidisciplinary approach. CT = computed tomography, VA = visual acuity, CBCT = cone beam computed tomography, TED = thyroid eye disease, MRI = magnetic resonance imaging, OOC = odontogenic orbital cellulitis, RAPD = relative afferent pupillary defect.
Topics: Adolescent; Adult; Decompression, Surgical; Female; Follow-Up Studies; Humans; Male; Middle Aged; Orbital Cellulitis; Retrospective Studies; Stomatognathic Diseases; Tomography, X-Ray Computed; Young Adult
PubMed: 32685776
DOI: No ID Found -
Internal Medicine (Tokyo, Japan) Aug 2021
Topics: Anti-Bacterial Agents; Humans; Ludwig's Angina
PubMed: 33583883
DOI: 10.2169/internalmedicine.5477-20 -
Cleveland Clinic Journal of Medicine Dec 2021
Topics: COVID-19; COVID-19 Vaccines; Cellulitis; Humans; Myositis; SARS-CoV-2
PubMed: 34857596
DOI: 10.3949/ccjm.88a.21038