1/787. Hemophilus influenzae biotype III cellulitis in an adult. The case of a patient with systemic lupus erythematosus presenting with severe leg cellulitis caused by Hemophilus influenzae non-B biotype III is reported. skin infections caused by H. influenzae in general, and of the extremities in particular, seem to be rare in adults. This is the first reported case of cellulitis caused by H. influenzae biotype III. The infection was treated successfully with antibiotics. This case highlights the importance of blood cultures and prompt antimicrobial treatment in febrile adults with cellulitis, especially immunocompromised patients. ( info) |
2/787. A case of acute phlegmonous gastritis successfully treated with antibiotics. Acute phlegmonous gastritis is a rare disorder in which bacterial infection occurs in the gastric wall. gastrectomy involving the affected area has been thought to be an effective form of treatment. The authors report a case of a 32-year-old woman who had severe upper abdominal pain without signs of peritoneal irritation. endoscopy showed edematous and reddened gastric mucosa with a mass lesion in the gastric antrum. Endoscopic ultrasonography showed thickening of the antral wall and a low-echoic mass in the gastric antrum, thought to represent a fluid collection. White pus was aspirated from the mass. Localized type of acute phlegmonous gastritis with a gastric abscess was diagnosed. culture of the pus showed streptococcus pneumoniae. Through early diagnosis without laparotomy, the patient's gastritis was successfully treated with antibiotics alone. ( info) |
3/787. abscess formation as a complication of parenteral methylphenidate abuse. case reports of five patients suffering from either skin abscesses or cellulitis following parenteral methylphenidate abuse are presented. Four patients had similar lesions consisting of abscesses or cellulitis which demonstrated typical signs and symptoms of an infective process and were treated with local symptomatic therapy, incision and drainage if indicated, and systemic antibiotics. The fifth patient suffered from a circular, necrotic, nonpurulent ulcer on the dorsum of the right foot which produced no local or systemic toxic effects. Attempts to culture a responsible organism yielded Streptococcus viridans, an organism which is normal flora of the skin and, although opportunistic, is generally considered nonpathogenic. These cases further substantiate the belief that local vasospasm, chemical irritation, or both, produced by the methylphenidate solution may primarily cause a necrotic ulcer susceptibble to secondary bacterial infection. ( info) |
4/787. Management of mandibular fascial space infection of odontogenic origin. Cellulitis is an acute, painful infection whose swelling is larger with diffuse borders. When palpated, early cellulitis can be very soft or doughfy; a severe cellulitis is almost always described as indurated or even as being "board-like". It can be innocuous in its early stages and extremely dangerous in its more advance, indurated, rapidly spreading stages. Randy, a 16 years old boy who thought that a regularly occurring toothache can advance into a life-threatening complication has a lot to be thankful for. The patient was referred to the pediatric dentistry Division by the E.R. doctors for further evaluation and management due to a swelling on the lower quadrant of his face. This was on the 8th day after he experienced the first pain on tooth no. 47. ( info) |
5/787. Wells' syndrome (eosinophilic cellulitis): correlation between clinical activity, eosinophil levels, eosinophil cation protein and interleukin-5. Wells' syndrome (WS) (eosinophilic cellulitis) is characterized by the presence of oedematous skin lesions associated with eosinophilia of the tissues. It has recently been observed that in patients with this disease, increased eosinophil cation protein (ECP) and interleukin (IL) -5 can be detected in peripheral blood, with T lymphocytes that have mRNA for this lymphokine. We present a patient with WS in whom we found a close correlation between clinical activity, eosinophils in blood and bone marrow, and ECP and IL-5 levels in peripheral blood and tissues. We underline the major part played by IL-5 in this disease. ( info) |
6/787. Vesicular carcinoma erysipelatodes. carcinoma erysipelatodes, also known as inflammatory metastatic carcinoma, is a type of cutaneous metastatic disease. We describe a 64-year-old woman with metastatic breast carcinoma who presented with a blistering erythematous eruption resembling erysipelas with formation of vesicles and bullae. She was found to have carcinoma erysipelatodes with a formation of vesicles and bullae. ( info) |
| Paranasal sinus osteoma is a slow-growing, benign, encapsulated bony tumor that may be commonly asymptomatic, being detected incidentally in 1% of plain sinus radiographs or in 3% of sinus computerized tomographic scans. In a patient presenting with orbital cellulitis and epiphora, computed tomography disclosed a large osteoma of the ethmoid sinus. Excision of the osteoma allowed recovery of vision, return of extraocular muscle function, and resolution of choroidal folds. Proptosis, diplopia, and visual loss are other frequent presenting signs of paranasal osteomas. epidemiology, diagnosis, treatment, and pathologic findings in paranasal sinus osteoma are reviewed. ( info) |
8/787. Fulminant meningococcal supraglottitis: An emerging infectious syndrome? We report a case of fulminant supraglottitis with dramatic external cervical swelling due to associated cellulitis. blood cultures were positive for neisseria meningitidis. The patient recovered completely after emergency fiberoptic intubation and appropriate antibiotic therapy. We summarize five other cases of meningococcal supraglottitis, all reported since 1995, and discuss possible pathophysiologic mechanisms. ( info) |
9/787. The meaning of "otherness" in healthcare planning. Otherness holds special meaning in healthcare planning. When clinicians assign the quality of "otherness" to a patient or a patient group, they may justify inadequate care by blaming the patient for the numerous management difficulties he or she presents. This response suggests that as a culture we need to be aware of the moral dimensions of otherness and recognize how this influences care. A case study is offered to illustrate the numerous barriers otherness poses in healthcare planning. ( info) |
| We report the first clinical use of a modified Dakin's solution (0.025% sodium hypochlorite [NaOCl]) to halt the progress of severe cutaneous vibrio vulnificus infection in a critically ill patient. The regimen used arose from an initial in vitro study designed to examine the sensitivity of Vibrio species to topical antimicrobial agents. Twenty-eight wound isolates were tested against the following eight topical preparations: silver sulfadiazine (Silvadene), nitrofurazone, mupirocin ointment (Bactroban), polymyxin b/bacitracin, mafenide acetate (Sulfamylon), nystatin/Silvadene, nystatin/polymyxin b/bacitracin, and 0.025% NaOCl solution. The results showed that V vulnificus, along with the other 18 Vibrio species tested, was most sensitive to the modified NaOCl solution. ( info) |