MyMedR

Fulltext Cutaneous tuberculosis mimicking cellulitis in an immunosuppressed patient

Chin PW, Koh CK, Wong KT

Singapore Med J, 1999 Jan;40(1):44-5.

A 28-year-old lady suffering from systemic lupus erythomatosus (SLE) with diffuse proliferative glomerulonephritis (DPGN) and who was on oral cyclophosphamide and prednisolone presented with left lower limb 'cellulitis'. The 'cellulitis' of the left lower limb failed to respond to usual antibiotics which prompted evaluation of the clinical diagnosis. The diagnosis is made based on the presence of granulomas, multinucleated giant cells and acid fast bacilli on the skin biopsy.

Matched MeSH terms: Cellulitis/diagnosis*

Bullous cellulitis as an extraordinary manifestation of a Vibrio cholerae O1 Ogawa infection

Ummu SF, Ding CH, Wahab AA, Tzar MN

Trop Biomed, 2023 Jun 01;40(2):170-173.

PMID: 37650403 DOI: 10.47665/tb.40.2.007

Vibrio cholerae is a gram-negative bacterium synonymous with its namesake disease, cholera. Thus, gastrointestinal symptoms are the norm and V. cholerae is very rarely associated with skin and soft tissue infections. We describe a case of a 63-year-old Chinese woman with multiple medical comorbidities on corticosteroid therapy who developed fever and a painful swelling on her left leg after being pricked by a branch while gardening. There was no abdominal pain, vomiting or diarrhea. A diagnosis of bullous cellulitis was made clinically, and blood was sent for bacteriological culture. A beta-hemolytic commashaped gram-negative bacillus was isolated from the blood. It was also oxidase-positive and produced an acid/alkaline (A/K) reaction on triple sugar iron agar. It was identified biochemically as Vibrio cholerae. After additional testing, it was found to be of the O1 serogroup and Ogawa serotype. The infection resolved following a 10-day course of high-dose co-trimoxazole therapy.

Matched MeSH terms: Cellulitis/diagnosis

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/diagnosis

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/diagnosis

Subcutaneous gas in diabetes mellitus due to Aerobacter aerogenes infection

Da Costa JL

Med J Malaya, 1969 Mar;23(3):199-202.

PMID: 4240074

Matched MeSH terms: Cellulitis/diagnosis

Cellulitis: An unusual manifestation of Neisseria meningitidis infection

Muhd Yusoff NH, Zainol Rashid Z, Sulong A, Shafiee MN, Ismail Z

Malays J Pathol, 2019 Dec;41(3):351-354.

PMID: 31901921

INTRODUCTION: Neisseria meningitidis infections often cause severe meningitis as well as bacteraemia. However, cellulitis in meningococcal diseases have rarely been described. Here, we report a case of right lower limb cellulitis caused by N. meningitidis.

CASE REPORT: A 69-year-old woman presented with fever and lower limb swelling. She had diabetes mellitus, hypertension, dyslipidaemia and a history of surgical resection of vulvar carcinoma. N. meningitidis was isolated from her blood culture.

DISCUSSION: This report provides additional evidence in support of N. meningitidis as a cause of cellulitis.

Matched MeSH terms: Cellulitis/diagnosis

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/diagnosis

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/diagnosis*

"Fleshy" Skin Cellulitis: A Triggering Factor for ANCA Associated Vasculitis

Yang SC, Mustafar R, Kamaruzaman L, Wei Yen K, Mohd R, Cader R

Acta Med Indones, 2019 Oct;51(4):338-343.

PMID: 32041918

A 59-year-old lady with underlying hypothyroidism presented with acute contact dermatitis progressed to cellulitis with superimposed bacterial infection and acute kidney injury. She responded to initial management with antibiotics, but a week later, she had cutaneous and systemic vasculitis. Her skin biopsy consistent with immune-mediated leuko-cytoclastic vasculitis and her blood test was positive for cytoplasmic-anti-neutrophil cytoplasmic antibody (c-ANCA). A diagnosis of ANCA-associated vasculitis was made and she was treated with immunosuppressant with plasmapheresis and hemodialysis support for her kidney failure. Despite aggressive measures, the patient succumbed to her illness. This case report demonstrates that soft tissue infection could trigger the development of ANCA-associated vasculitis whilst a background of hypothyroidism serves as a predisposing factor as both condition were reported separately in a couple of case studies before.

Matched MeSH terms: Cellulitis/diagnosis*

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