1/20. Varicella complicated by group A streptococcal facial cellulitis.An increase has been recently noted in the incidence of life-threatening group A beta-hemolytic streptococcal (GABHS) infections in children recovering from varicella. We report our experience with a patient who required pediatric intensive care unit admission because of a serious GABHS infection 1 week after the onset of varicella. Emergency physicians must look for this complication in patients with varicella remaining abnormally febrile and presenting unusual manifestations.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/20. Ocular complications of the Fernand-Widal triad and its therapy.BACKGROUND: The Fernand-Widal triad (FWT) is the association of non-allergic intrinsic asthma, nasal polyposis and sensitivity to aspirin. The aim of this paper is to describe the possibility of ocular complications, which we found in 3 cases: in 1 case due to the FWT itself and in the other 2 as a result of corticosteroid treatment. methods: Three cases of the FWT with ocular complications were studied, and the pertinent literature was reviewed. RESULTS: No previous description of ocular involvement in individuals with FWT was found in the literature. In the first case, episodes of orbital cellulitis due to superinfected nasal polyposis were found as a complication produced by the disease. In the other 2 cases, corticosteroid treatment created complications: ocular hypertension in both cases and bilateral subcapsular cataracts in 1 case. CONCLUSIONS: Although not rare, the diagnosis of the FWT is often missed. This perhaps explains why no report of ocular complications has yet been published in the literature. Because of the serious clinical consequences, physicians involved in the treatment of these patients should be aware of this diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/20. A rare case of salmonella-mediated sacroiliitis, adjacent subperiosteal abscess, and myositis.We report the case of a 16-year-old female who was ultimately diagnosed with salmonella sacroiliitis, adjacent subperiosteal abscess, and myositis of the left iliopsoas, gluteus medius, and obturator internus muscles. Early and accurate recognition of this syndrome and other infectious musculoskeletal syndromes can prove difficult for the emergency physician, as these disease processes require special attention to pain of proportion to physical findings and a high index of suspicion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/20. Persistent cellulitis in a patient receiving renal dialysis.cryptococcus neoformans, an opportunistic fungus, may cause cutaneous disease by dissemination from primary lung infection or, more rarely, by direct cutaneous inoculation. Cellulitis in an immunocompromised host who does not respond to conventional antibacterial therapy should alert the physician to consider other diagnoses, including cryptococcal skin infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/20. erythromelalgia misdiagnosed as cellulitis.This case report examines the presentation of a patient with erythromelalgia that was misdiagnosed as cellulitis on several prior occasions. The presentation of bilateral acral edema and erythema, especially in the setting of myeloproliferative and/or connective tissue diseases, should alert the physician to the possibility of alternate diagnoses, including erythromelalgia. Treatments target symptom alleviation, as well as diagnosis and treatment of causative factors.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/20. Cellulitis in Grade III ankle sprain requiring treatment for antibiotic-resistant bacteria.This case report describes a novel occurrence of a Grade III ankle sprain complicated by cellulitis. The patient ultimately required aspiration of an extra-articular fluid collection and treatment with parenteral antibiotics due to worsening of the infection despite treatment with second-generation cephalosporins. This individual's infection was consistent with MRSA-cellulitis. Cellulitis, in the context of a preceding ankle sprain, has not been reported in the literature; the resultant edema from the injury may have served as the nidus for infection. MRSA comprises a significant proportion of soft-tissue infections in the ambulatory setting, and physicians should incorporate this trend into therapeutic strategies for their infected patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/20. retropharyngeal abscess presenting as benign neck pain.OBJECTIVE: To present a case of an uncommon presentation of cellulitis of the neck as benign neck pain. CLINICAL FEATURES: A 44-year-old man had severe neck pain and headaches for 2 weeks with an unknown cause. Minimal response to chiropractic treatment leads to coordination of treatment with the patient's primary care physician. Laboratory assessment and magnetic resonance imaging initially were viewed as insignificant but were repeated and showed a retropharyngeal abscess. INTERVENTION AND OUTCOME: chiropractic treatment did not reduce the patient's neck pain as expected. Fusion of C1 to C2 was eventually performed. CONCLUSION: neck pain is a common reason for patients to seek chiropractic care. This case shows an uncommon differential diagnosis for a patient who does not respond quickly to chiropractic treatment for neck pain.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/20. Clinically inapparent meningitis complicating periorbital cellulitis.Two young children with periorbital (preseptal) cellulitis were found to have meningitis despite having no signs of meningeal irritation and normal cerebrospinal fluid (CSF) cell counts and chemistries. These cases are reported to remind physicians caring for acutely ill children that periorbital cellulitis can have life-threatening complications and that meningitis can occur in the absence of significant clinical signs and in the presence of an initially normal CSF.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/20. Serious bacterial infections in children. When can outpatient treatment be used?Several studies now support outpatient treatment of many serious bacterial infections in children, such as periorbital or buccal cellulitis, urinary tract infection, pneumonia, and abscess. However, an appropriate agent, that is, a third-generation cephalosporin with a long half-life, must be available and its effectiveness properly researched. In addition, children must be free of other illnesses and able to ingest fluids and maintain hydration, and their parents must be willing and able to cooperate with an outpatient treatment regimen. family physicians can maintain the close patient and family contact needed to facilitate this form of therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/20. An unusual case of orbital cellulitis.Munchausen's syndrome, an unusual disorder related to malingering and hysteria, is occasionally seen by the ophthalmologist. Munchausen patients deliberately deceive and attempt to manipulate physicians 'through factitious signs and symptoms. They know they are acting, yet appear unable to control their actions. Unnecessary medical workups and inappropriate surgical interventions are common with this perplexing syndrome. An unusual case of orbital cellulitis that illustrates a number of these features is illustrated and the syndrome is reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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