Cellulitis Research Articles

Burosumab and Dental Abscesses in Children With X-Linked Hypophosphatemia.

X-linked hypophosphatemia (XLH) is a rare genetic disorder that disrupts skeletal and dental mineralization. In addition to rickets in children, XLH patients also have frequent spontaneous dental abscesses that increase the risk of tooth loss and may lead to facial cellulitis. Hypomineralized and hypoplastic dentin is the main driver of these infections. Conventional treatment (CT) of XLH improves this tissue defect and reduces the occurrence of dental abscesses. Burosumab is a recent treatment for XLH that targets excess circulating fibroblast growth factor 23 (FGF23), and its benefits on rickets have been demonstrated. It is not yet known whether burosumab improves dental manifestations of XLH. The main objective of our study was to compare the incidence of dental abscesses with XLH treated with either CT or burosumab. In this monocentric retrospective study, we measured and compared the incidence of dental abscess in children with XLH treated with either CT or burosumab, followed at our dental center for at least 1 year. The primary endpoint was the number of dental abscesses per month of dental follow-up. A total of 71 children were included in the study, with a mean ± standard deviation (SD) age at the start of dental follow-up of 7.86 ± 3.76. Thirty-eight children were treated with CT (53.5%) and 33 with burosumab (46.5%). All children treated with burosumab had previously been treated with CT. The mean number of dental abscesses per month of dental follow-up was significantly reduced in the burosumab group compared with the CT group (0.01 versus 0.04; p= 0.04). Burosumab treatment appears to be associated with a reduction in the number of dental abscesses in XLH children, compared with CT. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Impact on ruminant performance of feed additives

In order to elicit the desired reaction at animals, feed additives must be included in high concentrations in the diet. Microorganism-based feed additives for ruminants have been more popular over the last two decades, and this trend is expected to continue. Dairy farmers may utilize feed additives to enhance the nutritional content of their dairy cows' meals and boost revenues by using them properly. The use of supplements should not be seen as a substitute for well-balanced diets and sound feeding procedures, but rather as an addition to them. Although yeast biomass, a byproduct of the alcoholic beverage industry, has previously been employed as a protein source, research into feeding yeast as a probiotic began in the 1950s. Probiotics like yeast were only employed as a feed additive at a lesser level. It was in the 1940s and 1950s when Saccharomyces cerevisiae (Sc) was first used as a probiotic in tiny doses added to animal feed. Anaerobic cellulitis bacteria count and ruminal PH value may be improved by adding yeast to ruminant diets, according to research. mineral absorption is influenced by the patterns of volatile fatty acids.

Oral infections and gastric perforation peritonitis: What is the link?

IntroductionThe association of gastric perforation peritonitis with an oral infection is rarely reported in the literature. This work reports two cases of gastric perforation peritonitis associated with facial cellulitis or mandibular osteitis in order to analyze the causal link between these two pathological entities. ObservationsTwo patients, one 25 years old, the other 40 years old, were admitted to the surgical emergency room for epigastric pain with vomiting and cessation of matter and gas. Both patients had been taking nonsteroidal anti-inflammatory drugs for the treatment of dental pain. The clinical investigations concluded to a peritonitis by perforation of a peptic ulcer associated with a parotido-masseterine cellulitis in the first patient and with a mandibular osteitis in the second patient. A laparotomy coupled with antibiotic therapy was performed in both patients. Drainage of the facial collection was performed in the first patient. Treatment of the oral infection entry point was performed in both patients. The evolution was favorable in both patients. ConclusionThe use of anti-inflammatory drugs in the treatment of dental pain without precaution plays a determining role in this association. This work calls for an awareness for a change of behavior in the management of NSAIDs.

Necrotizing fungal preseptal cellulitis secondary to Candida orthopsilosis in a diabetes mellitus patient – A rare case report and review of literature

Non-albicans candida infection is an emerging threat in immunocompromised patients like those with diabetes mellitus, bone marrow transplant recipients, or HIV-positive patients. We report a rare case of necrotizing preseptal cellulitis extending to the cheek caused by Candida orthopsilosis in a young diabetic patient. Fungal etiology must be considered as a possible cause of preseptal and facial cellulitis in the setting of uncontrolled diabetes mellitus, which is unresponsive to broad-spectrum antibiotics even in the absence of a local nidus of infection in the paranasal sinuses or oral cavity.

Extensive Facial Cellulitis Due to Staphylococcal Infection in Young, Immune-Competent Females

Skin and soft-tissue infections are commonly caused by Staphylococcus and Streptococcal infections. They usually cause self-limiting localized infection and responds well to antibiotic therapy. At times, they can cause dreadful infections in unfavorable conditions. Here, we discuss two cases of extensive Staphylococcal infections in healthy females. Both patients, presented with diffuse swelling of the entire half of the face. It was associated with fever, peri-orbital swelling, and swelling of upper/lower lips with multiple areas of subcutaneous pus collection. It started as a painful lesion over the cheek, which started spreading because of repeated probing of the lesion by the patients. Pus culture yielded heavy growth of Staphylococcus. In view of the massive upper airway edema, they required tracheostomy to secure airway. They were treated with intravenous antibiotics, and incision and drainage were done to relieve pus collections. They showed a dramatic response to treatment and they did not develop further complications. This article highlights the danger associated with the probing of infective lesions over the face. Young females often have a tendency to pinch acne or any other lesions over the face due to cosmetic concerns. It is essential to educate patients about the risks associated with such habits.

Assessment of venous Doppler ultrasound findings of acute unilateral lower limb swelling in a tertiary facility in central Ghana: a retrospective analytical study

BackgroundUnilateral lower limb swelling has wide differential diagnoses with varying treatment plans, requiring an early and accurate diagnosis. Doppler ultrasound offers an extensive examination of the vascular system providing a platform for diagnosis and avoidance of unnecessary invasive procedures. Thus, it becomes pertinent to ensure that all the sonographic information required for the accurate diagnosis of a swollen lower limb is documented and critically analyzed in our setting, hence this study.ResultsThe records of a total of 151 patients with acute unilateral lower limb swelling were retrieved, females constituted the majority (51.7%). The overall mean age was 58.70 ± 16.71 years. Statistical significance was specified at p ≤ 0.05 for this study. The males were on the average 1.86 years younger than the female, but this difference was not statistically significant (p = 0.495). Patients older than 60 years constituted the majority 72 (47.7%) followed by the 40–60-year age category 61 (40.4%), and the left lower limb was affected more often 82 (54.3%). Multiple inguinal lymphadenopathy 82 (35.7%) and edema with thickened skin and subcutaneous layers 67 (29.1%) were the two most recurrent ultrasound features. There was no significant association between the sonographic features and the diagnoses made for acute unilateral lower limb swelling, except for the feature of edema with thickened skin and subcutaneous layers (p = 0.004) and the diagnosis of cellulitis (p = 0.047) that increased significantly with age.ConclusionMultiple inguinal lymphadenopathy and edema of the skin and subcutaneous layers were the most recurrent ultrasound features with cellulitis as the main diagnosis for acute unilateral lower limb swelling in our setting. Edema with thickened skin and subcutaneous layers and cellulitis both increased significantly with age. Sonographers, sonologists, and radiologists must be on the look-out for these in their practices.

Medical Infrared Thermography in Odontogenic Facial Cellulitis as a Clinical Decision Support Tool. A Technical Note.

Background: Odontogenic cellulitis are frequent infections of the head and neck fascial spaces that can sometimes spread and be life-threatening, requiring urgent hospitalization. Early diagnosis of facial cellulitis with diffuse inflammatory process is crucial in patient management but not always obvious in the field. Medical infrared thermography (MIT) is a noninvasive tool increasingly used to evaluate skin temperature maps and delineate inflammatory lesions. Objective: The aim of this work was to evaluate the use of MIT to improve the clinical examination of patients with facial cellulitis. Methods: Image processing work was carried out to highlight the thermal gradient resulting from inflammation linked to infection, in 2 patients with facial cellulitis. Results: In real-time, MIT allowed to precisely locate the inflammatory focus linked to cellulitis with no propagation to danger areas such as infraorbital space or around pharyngeal axis. Conclusions: Here, we show the first cases using MIT as a powerful complementary tool in the clinical evaluation of patients with facial cellulitis. Significance: This technology could help optimize the hospitalization decision through a facilitated assessment of infection spread in head and neck tissues and helping to incision for drainage.

452 Dermal Filler Injection Leading to Facial Cellulitis: A Case Report

Abstract Background Aesthetic medicine is a rapidly expanding field that is progressively becoming a normal part of society’s health and beauty regime. Hyaluronic Acid dermal filler injections are the second most widely performed aesthetic procedure, following Botulinum Toxin type A. Although serious complications are rare, they can have a detrimental impact on aesthetic outcome and general health. Infections following dermal fillers can be difficult to treat and have the potential to require hospital admission, intravenous antibiotics and surgical intervention. Case description We present a case of a 41-year-old female who suffered from facial cellulitis as a consequence of palpebro-malar groove dermal filler injections. The patient had 0.1ml of Monalisa dermal filler injected over her right malar prominence and suffered complications 6 days later, which eventually lead to the need for hospital admission on day 12 following the procedure for intravenous antibiotics. The management of this aesthetic procedure complication is outlined to highlight the risks and serious complications of these procedures. Conclusions Facial cellulitis is a rare adverse event following facial filler injection; however, it is an important risk factor to discuss during the consent process for these procedures. In addition, it is important that a highly trained and skilled professional performs these injections using a sterile non-touch technique due to the potential for serious complications and the anatomical proximity to vital structures.

Assessment of the Knowledge, Attitude, and Practice of Antibiotic Prescription among a group of Dentists in Egypt: A cross-sectional survey

 Objectives: The purpose of this survey is to investigate the knowledge, attitudes and practices related to antibiotic prescription patterns in a group of dentists in Egypt.  Materials and Methods: A cross-sectional survey was conducted electronically using online google forms. It included inquiries in the form of close-ended questions to be answered in tick-box format, the questions mainly uncovered, the participants’ “Knowledge” about the problem of antibiotic resistance and its association with professional mal practices, and also their “Attitudes and practices” concerning antibiotic prescriptions in different clinical conditions. 500 participants answered the questionnaire over a period of three months.  Results: Most of the participants prescribed Amoxicillin or Amoxicillin + clavulanic acid in conditions that warrant antibiotics usage. A comparable proportion preferred a treatment duration of 5-7 days. Although, 96% of the responses came in favor of antibiotic prescription in serious clinical conditions as facial cellulitis, still variable proportions of the sample chose to prescribe antibiotics for conditions that do not necessitate their usage as “localized intra-oral abscesses”, “sinus tracts and fistulas”, “luxation injuries” and “managing viral infections”.  Conclusions: Although the participants showed considerably adequate knowledge of the bacterial resistance problem, their practices showed varying degrees of deviation from the guidelines of antibiotic prescriptions set by the AAPD.

A UNIQUE CASE OF REGIONAL ODONTODYSPLASIA

<h3>BACKGROUND</h3> Regional odontodysplasia is a rare condition involving defective enamel and dentin in a group of adjacent teeth. It may also include calcifications within the dental pulp and/or dental follicle.^1,2 First described by Hitchin in 1934,³ regional odontodysplasia affects dental mesodermal and ectodermal tissues along particular segments of the maxilla and/or mandible in the primary and/or permanent dentitions. There is a sex predilection, affecting women more than men.⁴ The current case is of a 6-year-old girl who presented with asymmetry of the face at a children's hospital in the eastern United States. <h3>CASE REPORT</h3> A 6-year-old female patient presented with a history of extractions of abscessed teeth #H and #I. Tooth #I was extracted because of abscess and facial cellulitis. The patient was admitted for intravenous antibiotics. Medical history was noncontributory. Dental history was positive for a drooping upper left lip and expansion of the upper left alveolar ridge. Panoramic and multiple periapical radiographs were acquired. Radiographically, the permanent maxillary left first and second molars and primary second molar had defective enamel and dentin along with taurodontism. The pulp chamber and canal were elongated. These features had the appearance of "ghost teeth." The bone around the maxillary left posterior aspect was also affected. <h3>DISCUSSION/CONCLUSIONS</h3> The presented tooth specimen exhibited irregular, abnormally distributed dentinal tubules. Globular calcified masses within the pulp were seen. Based on clinical, histopathologic, and radiographic findings, the case was diagnosed as regional odontodysplasia. Treatment included comprehensive dental care including endodontic, prosthodontic, orthodontic, and surgical intervention. Regional odontodysplasia is a rare developmental anomaly. It presents with a slight female predilection in a bimodal age distribution, most commonly affecting a single quadrant, with the maxilla more commonly involved. Clinical manifestations may include hyperplastic gingiva, failure of tooth eruption, periapical inflammation, bony changes, alterations of the dentition, and cutaneous nevi in the affected area.⁵

Intra-Oral Incision in Facial Cellulitis without Fluctuation: A Case Report

Oral examination and Orthopantomogram are essential in diagnosis of facial cellulitis. Incision is mandatory and life-saving, even if there is no fluctuation of pus to allow relief of gases, also, immediate warm saline mouthwash help localization and drainage of pus.

Treatment Dissecting Cellulitis of the Scalp With Secukinumab.

Treatment Dissecting Cellulitis of the Scalp With Secukinumab.

Cellulitis in children: a retrospective single centre study from Australia

AimTo characterise the epidemiology, clinical features and treatment of paediatric cellulitis.MethodsA retrospective study of children presenting to a paediatric tertiary hospital in Western Australia, Australia in 2018. All inpatient records...

Cellulitis: management, diagnosis and what nurses need to know

Cellulitis: management, diagnosis and what nurses need to know

A Review Study on Cellulitis

Cellulitis is a clinical condition which is characterised by reddishness, soreness, localized pain, erythema, swelling and formation of abscess in the leg, pyrexia and an increase in the heartbeat. It is the infection of the sub-cutaneous tissue and dermal layer usually found complicating a wound or ulcer. It is considered an infectious disease as it causes morbidity and mortality. It is also called skin diseases, as the skin is involved and lacks sharp demarcation from uninvolved skin. Cellulitis spreads rapidly and is pyogenic in nature and is frequently associated with lymphangitis and fever. Streptococci (streptococci pyogenes) and staphylococcus aureus are the two species which causes cellulitis. Five types of cellulitis can be classified they are facial cellulitis, periorbital cellulitis, breast cellulitis, perianal cellulitis. Diagnosis of cellulitis is based on morphological features of the lesion and a CT scan is required for determining cellulitis. By the visual inspection, the cellulitis is spotted. The common risk factor for cellulitis is oedema. If the cellulitis patient has Diabetes Mellitus or injury in the skin or any inflammation in the liver, they are considered to be in a dangerous state. Non-Steroidal Anti-Inflammatory Drugs are prescribed to decrease the clinical features. Clindamycin, Dicloxacillin are antibiotics that are administered to cure cellulitis. This review discusses the general information regarding cellulitis, its clinical indications, pathophysiology, microbiology and its treatment.

Bilateral red ears

Milian ear sign is a specific clinical finding that aides in differentiating erysipelas from facial cellulitis. The anatomical absence of subcutaneous tissue in pinna brings about this clinical distinction. Although bilateral Milian ear sign is rare, erysipelas should be considered when encountering patients presenting with red ears, among other differentials such as Ramsay-Hunt syndrome, relapsing polychondritis, auricular perichondritis, and red ear syndrome.

Social determinants of seeking emergency and routine dental care in Saudi Arabia during the COVID-19 pandemic

BackgroundBetween March and June 2020, closing dental clinics during the COVID-19 pandemic except for emergency dental care was recommended. It is documented that health-seeking behaviors change during pandemics. The objective of this study was to examine social determinants associated with decisions to seek dental care in Saudi Arabia during the COVID-19 pandemic.MethodsA total of 4372 participants were invited to this cross-sectional web-based survey distributed from April 21 to June 20, 2020. The survey included a list of emergency, urgent, and routine dental procedures. Participants were asked if they would seek dental care for these conditions during the pandemic, and what pain severity would make them seek dental treatment. Logistic regression models were performed for predicting variables that explain the decision to go or not to go to the dental clinic during the pandemic for each dental condition.ResultsA total of 3443 responded to this survey. The emergency dental situation participants were most willing to go to the dental clinic for was trauma involving facial bones compromising the airway (94.5%). Only 65.8% were willing to seek care for facial cellulitis compromising the airway. On average 35.2% reported seeking teleconsultation as the first step. Eighteen percent of participants were still willing to go to the dental clinic during the pandemic for routine dental procedures. Multiple logistic regression showed that females (Odds Ratio (OR): 1.6, OR 95% CI 1.3, 1.9), people who had never visited a dentist (OR: 1.8, OR 95% CI 1.3, 2.5), and people living in metropolitan regions (OR: 1.8, OR 95%: 1.4, 2.3) had higher odds for not seeking emergency dental care during this pandemic. The pain threshold for seeking dental care during the pandemic was 7 out of 10. Female, those who never visited a dentist, and those from urban regions reported higher pain threshold before seeking dental care (P value < 0.001).ConclusionSocial disparities were found in emergency dental care seeking decision-making in Saudi Arabia during the COVID-19 pandemic. It was alarming that some people were afraid to seek dental care for life-threatening dental emergencies as cellulitis during this pandemic. This reflects the importance of increasing public health awareness and governmental regulations.

Facial cellulitis caused by Giant parotid sialolith: a minimally invasive treatment for a rare occurrence

Sialolithiasis is a common disease that affects the major salivary glands and can occur at any age. Parotid glands are rarely involved and, even rarer are the cases of sialoliths larger than 10 mm. This report presents the rare case of a giant parotid sialolith associated with facial cellulitis in a 75-year-old man. The treatment involved initially non-surgical approach followed by a minimally invasive surgery to restore health and function. The treatment protocol was completely successful and proved effective in clinical and surgical management of giant parotid sialolith associated with facial cellulitis.

Empiric and Novel Chemotherapeutic Therapy with Combination Antibiotic Treatment in a Child with Facial Cellulitis Secondary to Odontogenic Abscess

Empiric and Novel Chemotherapeutic Therapy with Combination Antibiotic Treatment in a Child with Facial Cellulitis Secondary to Odontogenic Abscess

Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: A multicentric comparative study

During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients’ fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.