ABSTRACT
Orbital cellulitis is an uncommon complication resulting from a spectrum of disorders commonly found in pediatric practice. It usually occurs as a complication of infection of the paranasal sinuses, although it also can be caused by eyelid or dental juries, dental infection and external ocular infection. We studied the clinical, microbiological, and therapeutic features of 152 children diagnosed as periorbital cellulitis and 27 children with orbital cellulitis admitted to our hospital in a 16-year period from January 1983 to December 1998. Twenty-four percent of patients (43 cases) had positive cultures. Thirty children with septal or preseptal cellulitis developed neurological or ophthalmological complications. Intravenous or oral antibiotic administration was effective in 150 patients, but a significant proportion required surgery of the paranasal sinus or orbit (16%).
Subject(s)
Bacterial Infections/therapy , Cellulitis/therapy , Orbital Diseases/therapy , Algorithms , Bacterial Infections/microbiology , Cefotaxime/therapeutic use , Cellulitis/etiology , Child , Child, Preschool , Drug Therapy, Combination/therapeutic use , Female , Humans , Male , Orbital Diseases/etiology , Prospective Studies , Retrospective StudiesABSTRACT
La celulitis orbitaria es una patología relativamente infrecuente en la práctica pediátrica, normalmente aparece como complicación de la sinusitis, aunque también puede ser debida a traumatismos faciales o dentarios, infecciones dentarias, o infecciones óculo-lacrimales. Presentamos nuestra casuística de pacientes diagnosticados de celulitis peri u orbitaria durante los últimos 16 años desde enero de 1983 a diciembre de 1998, sus hallazgos clínicos, microbiológicos, y terapéuticos. 152 niños correspondían a celulitis periorbitarias y 27 niños a celulitis orbitarias. El 24 por ciento de los pacientes (43 casos) tenían cultivos positivos, 30 casos con celulitis peri u orbitaria desarrollaron complicaciones neurológicas u oftalmológicas, el tratamiento consistió en antibioterapia únicamente en 150 casos, precisando el 16 por ciento de los casos además tratamiento quirúrgico (AU)
Orbital cellulitis is an uncommon complication resulting from a spectrum of disorders commonly found in pediatric practice. It usually occurs as a complication of infection of the paranasal sinuses, although it also can be caused by eyelid or dental juries, dental infection and external ocular infection. We studied the clinical, microbiological, and therapeutic features of 152 children diagnosed as periorbital cellulitis and 27 children with orbital cellulitis admitted to our hospital in a 16-year period from January 1983 to December 1998. Twenty-four percent of patients (43 cases) had positive cultures. Thirty children with septal or preseptal cellulitis developed neurological or ophthalmological complications. Intravenous or oral antibiotic administration was effective in 150 patients, but a significant proportion required surgery of the paranasal sinus or orbit (16%) (AU)
Subject(s)
Child, Preschool , Child , Male , Female , Humans , Orbital Diseases , Bacterial Infections/therapy , Cellulite/therapy , Drug Therapy, Combination , Retrospective Studies , Cefotaxime/therapeutic use , Algorithms , Prospective StudiesABSTRACT
Cryptococcus neoformans is a nonfermentative yeast that requires oxygen for growth. The shaking of culture media achieves good oxygenation, promoting the growth of cryptococci. In this study, three test media (RPMI 1640, RPMI 1640-2% glucose, and buffered yeast nitrogen base ¿BYNB) recommended in the National Committee for Clinical Laboratory Standards M27A standard were examined. Growth abilities and minimum inhibitory concentrations (MICs) in microplates incubated at 35 degrees C for 48 h were determined. The results indicated that shaking and an inoculum size of 10(5) CFU/ml yielded optimal growth of this yeast. Compared to RPMI 1640, supplementation of RPMI 1640 with 2% glucose did not significantly improve growth of C. neoformans and resulted in an 8.7-h delay of exponential growth. Cryptococcal growth in RPMI 1640 at 24 h was notably better than that in RPMI-2% glucose, although by 48 h the growths were comparable. The MIC range of amphotericin B observed for the C. neoformans strains grown in RPMI 1640 with or without glucose was too narrow to allow the separation of susceptible and resistant strains based on clinical outcome. The widest ranges of MICs of flucytosine and fluconazole were obtained with BYNB. This work demonstrates the need for a new antifungal susceptibility test for C. neoformans.
Subject(s)
Antifungal Agents/pharmacology , Cryptococcus neoformans/drug effects , Culture Media/pharmacology , Cell Division/drug effects , Cryptococcus neoformans/growth & development , Glucose/pharmacology , Humans , Microbial Sensitivity Tests , Saccharomyces cerevisiae/chemistry , Specimen HandlingSubject(s)
Cystic Fibrosis/surgery , Lung Diseases, Fungal/etiology , Lung Transplantation , Lung/microbiology , Mitosporic Fungi , Postoperative Complications/microbiology , Antifungal Agents/therapeutic use , Drug Resistance, Microbial , Fatal Outcome , Graft Rejection/drug therapy , Graft Rejection/surgery , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Lung Diseases, Fungal/drug therapy , Male , Mitosporic Fungi/isolation & purification , Recurrence , ReoperationABSTRACT
An unusual case of granulocytic sarcoma infiltrating the parotid gland of a 17-year-old woman is reported. There was no evidence of acute myeloid leukemia or chronic myeloproliferative disease at time of diagnosis. The myeloid nature of the tumor was discovered with the aid of immunochemistry. The patient responded well to combined polychemotherapy and local radiotherapy. Eighteen months after diagnosis, the bone-marrow biopsy showed no signs of blast infiltration. Granulocytic sarcoma should be considered in the differential diagnosis of malignant tumors of the parotid gland, although it is rare.
Subject(s)
Leukemia, Myeloid/pathology , Parotid Neoplasms/pathology , Adolescent , Combined Modality Therapy , Female , Humans , Leukemia, Myeloid/therapy , Parotid Neoplasms/therapyABSTRACT
We report a case of cutaneous zygomycosis caused by Rhizopus arrhizus in a surgical wound following colostomy. The patient was a diabetic and in addition presented others risk factors. Zygomycosis was suspected when a necrotic wound surface appeared in the appropiate clinical setting. Diagnosis was confirmed on a combined histological and microbiological study. Extensive surgical resection, high doses of amphotericin B and treatment of the underlying conditions permitted the control of the infection.
Subject(s)
Abscess/etiology , Analgesia, Epidural/adverse effects , Exophiala/isolation & purification , Mycoses/etiology , Spinal Diseases/etiology , Abscess/drug therapy , Abscess/microbiology , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Epidural Space , Equipment Contamination , Female , Humans , Middle Aged , Mycoses/drug therapy , Mycoses/microbiology , Spinal Diseases/drug therapy , Spinal Diseases/microbiologySubject(s)
Kidney Transplantation , Nocardia Infections/microbiology , Nocardia asteroides , Pneumonia, Bacterial/microbiology , Aged , Anti-Bacterial Agents/therapeutic use , Female , Humans , Immunocompromised Host , Nocardia Infections/drug therapy , Nocardia asteroides/drug effects , Pneumonia, Bacterial/drug therapyABSTRACT
Wegener's granulomatosis (WG) is characterized by necrotizing granulomas and vasculitis that may affect any organ. The upper and lower respiratory tract and kidney usually are affected. WG is diagnosed by determination of anti-neutrophil cytoplasm antibody (ANCA), a highly sensitive and specific test that is particularly important in the early stages to achieve the best prognosis. We describe a case in a 28-year-old man that exemplifies some of the diagnostic features of WG.
