ABSTRACT
A 12-year-old girl presented with a 1 week history of orbital swelling associated with granuloma, purulent discharge from the eye and preauricular and submandibular lymphadenopathy. Initial conventional treatment for presumed preseptal cellulitis was unsuccessful. Despite treatment with broad spectrum antibiotics, the preseptal cellulitis progressed to orbital cellulitis with restriction of eye movements in addition to the marked conjunctival chemosis and haemorrhage. A detailed history revealed she had been in close contact with newborn kittens at home and biopsy of the granuloma demonstrated Bartonella species, confirming the diagnosis of cat scratch disease. The child received a course of appropriate oral and topical antibiotics and steroids. Unfortunately eyesight in the right eye remains poor on follow-up.
Subject(s)
Cat-Scratch Disease/diagnosis , Orbital Cellulitis/diagnosis , Adrenal Cortex Hormones/therapeutic use , Animals , Anti-Bacterial Agents/therapeutic use , Cat-Scratch Disease/drug therapy , Cats , Child , Diagnosis, Differential , Female , Humans , Orbital Cellulitis/drug therapy , Orbital Cellulitis/microbiologySubject(s)
Meconium Aspiration Syndrome/therapy , Practice Patterns, Physicians'/statistics & numerical data , Amniotic Fluid , Bronchoalveolar Lavage/statistics & numerical data , Bronchodilator Agents/therapeutic use , Epoprostenol/therapeutic use , Extracorporeal Membrane Oxygenation/statistics & numerical data , Humans , Infant, Newborn , Infusions, Parenteral/statistics & numerical data , Magnesium Sulfate/therapeutic use , Nitric Oxide/therapeutic use , Oropharynx , Pulmonary Surfactants/therapeutic use , Respiration, Artificial/statistics & numerical data , Sodium Chloride/administration & dosage , Suction/statistics & numerical data , Surveys and Questionnaires , Syndrome , Tolazoline/therapeutic use , Trachea , United Kingdom , Vasodilator Agents/therapeutic useABSTRACT
We report a case of mycetoma of the sole of the foot in a 10-year-old caused by Nocardia brasiliensis. It was treated successfully with a combination of trimethoprim-sulfamethoxazole, dapsone and rifampicin.
