Negative pressure wound therapy in preseptal orbital cellulitis complicated with necrotizing fasciitis and preseptal abscess.

PURPOSE: Preseptal cellulitis (PC) may be locally complicated with abscess formation and necrotizing fasciitis. If not treated promptly and adequately, it may result in further complications. The authors report a series of patients where negative pressure wound therapy (NPWT) proved a safe and valuable adjunct therapy in avoiding complications of PC and in accelerating wound healing. METHODS: A 4 patient case series. Four male patients (11 months to 58 years old) with unilateral complicated PC. INTERVENTIONS: Patients were admitted with PC and treated initially with specific intravenous antibiotic therapy. These patients did not respond adequately; therefore, surgical drainage and/or debridement were performed. After surgery, persistent edema and purulent discharge was observed prompting the need for adjunct NPWT every 48 to 72 hours. NPWT is the use of vacuum through a wound filler material covered with an airtight drape connected to a pump. Complete ophthalmologic examination was performed after each 48-hour cycle. Length of hospital stay, days from surgery to discharge, days from start of NPWT to discharge, clinical improvement, and safety. RESULTS: Four patients were diagnosed with PC between 2 and 5 days of evolution. Two diabetic adults developed the condition secondary to trauma, the adolescent as a result of a cosmetic piercing, and the infant associated to sinusitis. NPWT reached -125 mm·Hg, except for the infant who received -75 mm·Hg. The average number of days necessary for improvement with NPWT was 6.7 days. Only 2 patients required surgical reconstruction. Time from debridement to discharge was in average 13.5 days. No ocular complications were observed, and follow up was satisfactory with normal eyelid function and aesthetics and preserved visual acuity. CONCLUSIONS: NPWT proved to be safe and effective for treating locally complicated PC as an adjuvant therapy to antibiotic and surgical treatment that decreased the length of hospital stay, and the time for recovery in patients that were slow responders. No ocular complications were observed in any of these patients' follow up ranging from 1 to 4 years.

[Erythema multiforme secondary to cutaneous Trichophyton mentagrophytes infection]. / Eritema multiforme secundario a infección por Trichophyton mentagrophytes.

Erythema multiforme is an acute self-limited cutaneous syndrome associated in more than 50% of the cases with herpes simplex virus infection; but it can also be a consequence of other infectious agents or drugs. We report on a 24 year-old female patient with erythema multiforme secondary to Trichophyton mentagrophytes var. mentagrophytes cutaneous infection acquired from contact with animals in a research laboratory.

Eritema multiforme secundario a infección por Trichophyton mentagrophytes / Erythema multiforme secondary to cutaneous Trichophyton mentagrophytes infection

El eritema multiforme es un síndrome autolimitado agudo de la piel, asociado en un 50% a infecciones porvirus del herpes simple, pero se puede desencadenar por otros agentes infecciosos o medicamentos. Sepresenta el caso de una paciente de 24 años de edad, con un cuadro de eritema multiforme secundario auna tiña de la piel lampiña por Trichophyton mentagrophytes var. mentagrophytes adquirida de un animalde laboratorio(AU)

Erythema multiforme is an acute self-limited cutaneous syndrome associated in more than 50% of thecases with herpes simplex virus infection; but it can also be a consequence of other infectious agents ordrugs. We report on a 24 year-old female patient with erythema multiforme secondary to Trichophytonmentagrophytes var. mentagrophytes cutaneous infection acquired from contact with animals in a researchlaboratory(AU)