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Fulltext A fatal case of Vibrio vulnificus cellulitis with septicaemia

Zetti ZR, Norazlah B, Raha AR

Med J Malaysia, 2009 Sep;64(3):246-7.
PMID: 20527281 MyJurnal

Vibrio vulnificus is a gram-negative marine bacterium that may cause local wound infection, distinctive soft tissue infection, gastroenteritis and septicaemia with a high mortality rate. A healthy man presented with severe abdominal pain, diarrhoea and fever followed by development of multiple blisters, cellulitis and necrotizing fasciitis of the lower limbs, who progressed rapidly to fulminant sepsis caused by this organism. Vibrio vulnificus septicaemia should be suspected in the presence of sepsis and progressive soft-tissue infection with recent history of raw seafood consumption.

Matched MeSH terms: Cellulitis/microbiology*
Bilateral orbital cellulitis due to Neisseria gonorrhoeae and Staphylococcus aureus: a previously unreported case

Raja NS, Singh NN

J Med Microbiol, 2005 Jun;54(Pt 6):609-611.
PMID: 15888472 DOI: 10.1099/jmm.0.46031-0

Cellulitis of the orbit is a common cause of proptosis in children, and also frequently arises in the elderly and the immunocompromised. The condition is characterized by infection and swelling of the soft tissues lining the eye socket, pushing the eye ball outwards and causing severe pain, redness, discharge of pus and some degree of blurred vision. There is a small risk of infection spreading to the meninges of the brain and causing meningitis. This paper reports the case of an adult in whom polymicrobial bilateral orbital cellulitis had developed due to Staphylococcus aureus and Neisseria gonorrhoeae infection. N. gonorrhoeae infections are acquired by sexual contact. Although the infection may disseminate to a variety of tissues, it usually affects the mucous membranes of the urethra in males and the endocervix and urethra in females. To the authors' knowledge this is the first report of polymicrobial bilateral orbital cellulitis due to S. aureus and N. gonorrhoeae in medical literature.

Matched MeSH terms: Cellulitis/microbiology*
Cellulitis due to Shewanella algae: Crucial diagnostic clues from basic microbiological tests

Ding CH, Wahab AA, Muttaqillah NAS, Kamarudin N, Saarah WR

Trop Biomed, 2019 Dec 01;36(4):883-887.
PMID: 33597461

Shewanella spp. are infrequently implicated in human infections but they are emerging pathogens with particular significance in regions with warm climates, such as Southeast Asia. This is a case of a middle-aged diabetic and hypertensive man who presented with worsening congestive heart failure symptoms associated with fever and a painful right leg. His right leg had numerous scabs and was tender, warm and erythematous. He was provisionally diagnosed with decompensated heart failure precipitated by cellulitis and uncontrolled hypertension. His blood grew non-fermentative, oxidase-positive and motile gram-negative bacilli which produced hydrogen sulfide on triple sugar iron agar. When cultured on blood agar, mucoid and weakly β-haemolytic colonies were observed after 48 hours. API 20 NE named the isolate as Shewanella putrefaciens but 16S rRNA sequence analysis identified the organism as Shewanella algae. The patient was treated with a 10-day course of ceftazidime, which resulted in the resolution of the cellulitis.

Matched MeSH terms: Cellulitis/microbiology*
Cellulitis in human brucellosis: An atypical presentation

Subramaniam K, Ali SU

Malays J Pathol, 2019 Dec;41(3):359-364.
PMID: 31901923

INTRODUCTION: Brucellosis is a zoonotic disease with variable clinical manifestations and atypical presentation in humans. Human brucellosis cases are not seen often in Malaysia.
CASE REPORT: This is a case report of 19 years old gentleman who presented with fever, lower limb redness, pain and swelling. He was initially treated as cellulitis. However, based on the recovery of Brucella melitensis from his blood culture, he was later diagnosed to have brucellosis. He had a history of consumption of fresh goat's milk and uncooked meat which could have been the possible modes of transmission. Brucella serology IgM and IgG were both positive, and anti-Brucella immunocapture agglutination test (BrucellaCapt) was also positive with a titer of 1:2560. He was treated with six weeks of oral doxycycline 100 mg twice daily and oral rifampin 450 mg twice daily.
DISCUSSION: This is a case of human brucellosis with atypical cutaneous involvement.

Matched MeSH terms: Cellulitis/microbiology*
Cutaneous melioidosis and necrotizing fasciitis with pulmonary involvement in a chicken seller

Ariza A

Southeast Asian J. Trop. Med. Public Health, 2008 Jul;39(4):656-8.
PMID: 19058602

Melioidosis is endemic in Malaysia. Cutaneous melioidosis is one manifestation and it may progress to necrotizing fasciitis. The case highlights a 46-year-old male, a chicken-seller who presented with scalp cellulitis which later progressed to necrotizing fasciitis and pneumonia are presented here. It illustrates several key features of the presentation, prompt laboratory diagnosis and early treatment of melioidosis which saved the patient's life.

Matched MeSH terms: Cellulitis/microbiology
Fulltext Clinical characteristics and outcomes of paediatric orbital cellulitis in Hospital Universiti Sains Malaysia: a five-year review

Mohd-Ilham I, Muhd-Syafi AB, Khairy-Shamel ST, Shatriah I

Singapore Med J, 2020 Jun;61(6):312-319.
PMID: 31598730 DOI: 10.11622/smedj.2019121

INTRODUCTION: Limited data is available on paediatric orbital cellulitis in Asia. We aimed to describe demographic data, clinical presentation, predisposing factors, identified microorganisms, choice of antibiotics and management in children with orbital cellulitis treated in a tertiary care centre in Malaysia.
METHODS: A retrospective review was performed on children with orbital cellulitis aged below 18 years who were admitted to Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2013 and December 2017.
RESULTS: A total of 14 paediatric patients fulfilling the diagnostic criteria for orbital cellulitis were included. Their mean age was 6.5 ± 1.2 years. Boys were more likely to have orbital cellulitis than girls (71.4% vs. 28.6%). Involvement of both eyes was observed in 14.3% of the patients. Sinusitis (28.6%) and upper respiratory tract infection (21.4%) were the most common predisposing causes. Staphylococcus aureus (28.6%) was the leading pathogen. Longer duration of hospitalisation was observed in those infected with methicillin-resistant Staphylococcus aureus and Burkholderia pseudomallei. 10 (71.4%) patients were treated with a combination of two or three antibiotics. In this series, 42.9% had surgical interventions.
CONCLUSION: Young boys were found to be more commonly affected by orbital cellulitis than young girls. Staphylococcus aureus was the most common isolated microorganism. Methicillin-resistant Staphylococcus aureus and Burkholderia pseudomallei caused severe infection. Sinusitis and upper respiratory tract infection were the most common predisposing factors. A majority of the children improved with medical treatment alone. Our findings are in slight disagreement with other published reports on paediatric orbital cellulitis, especially from the Asian region.

Matched MeSH terms: Orbital Cellulitis/microbiology*
Chaetomium globosum Cutaneous Fungal Infection Confirmed by Molecular Identification: A Case Report from Malaysia

Mohd Tap R, Sabaratnam P, Ahmad NA, Abd Razak MF, Hashim R, Ahmad N

Mycopathologia, 2015 Aug;180(1-2):137-41.
PMID: 25894509 DOI: 10.1007/s11046-015-9890-5

An 11-year-old girl presented with multiple blisters on her the right foot complicated with cellulitis. The conventional and molecular identification were performed on the culture. The internal transcribed spacer (ITS) region in rRNA gene of the isolate was amplified by PCR. The sequence of the amplified ITS region matched 99 % with that of Chaetomium globosum in the GenBank. This is the first report describing C. globosum causing cutaneous infection in Malaysia.

Matched MeSH terms: Cellulitis/microbiology