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What Is It and How Is It Treated?

Nasal vestibulitis is when there is an infection in your nasal vestibule. Your nasal vestibule is located just inside your nostril or nose opening. It’s lined with skin that has thick hairs. The hairs help to stop dust, dirt, and other particles from entering your lungs.

It’s a common infection but can lead to some rare and life-threatening complications. 

Symptoms of Nasal Vestibulitis

The symptoms of nasal vestibulitis include:

  • Fever
  • Painful swelling of your nose
  • Boils (furuncles) in your nasal vestibule 
  • Dryness
  • Crusting in your nostrils
  • Nosebleeds
  • Bumps filled with pus

If your nasal vestibulitis persists or keeps coming back, see your doctor. They may need to carry out some tests to rule out basal or squamous cell carcinoma.

Squamous cell carcinoma is a common form of skin cancer and it can be found in many parts of your body. If left untreated, it can spread to other parts of your body.

Squamous cell carcinoma of the nasal vestibule tends to be rare. It can sometimes be misdiagnosed as nasal vestibulitis.

Causes of Nasal Vestibulitis

Nasal vestibulitis is an infection caused by the Staphylococcus bacteria.

There are many types of bacteria that live in our noses and they’re usually harmless. But once there’s an injury to the tissues inside the nose, the bacteria can enter the wound and cause infection.

Injuries to your nasal vestibule can be caused by: 

  • Plucking your nose hair
  • Blowing your nose excessively  
  • Picking your nose
  • Nose piercing 
  • Objects stuck in the nose (most common in young children)

There could also be underlying reasons for this infection. One possible reason is viral infections such as herpes simplex and herpes zoster.

People with weakened immune systems, such as those with diabetes and autoimmune diseases, may be more prone to nasal vestibulitis.

In a study of 118 people with nasal vestibulitis, 10% of them also had diabetes:

Researchers also found that cancer patients taking targeted anticancer drugs frequently develop nasal vestibulitis. Of 115 cancer patients who developed nasal vestibulitis when on anticancer treatment, 13% of them had repeated occurrences.

Researchers studying cancer patients found that nasal vestibulitis symptoms are common among those seeking cancer treatment. Yet doctors don’t always record or treat them. Some doctors list these symptoms as allergies or nosebleeds instead.

There have been few research studies on nasal vestibulitis. Experts say it’s a common condition, especially among older adults.

Complications of Nasal Vestibulitis

Your nose is part of the “danger triangle” of your face. This area of your face covers the corners of your mouth to your nose bridge. It’s a dangerous area because many of the blood vessels in this area are directly linked to your brain. This means that infections here may spread to your brain, although this is very rare. 

Some possible complications of nasal vestibulitis include the following.

Facial cellulitis.Cellulitis is a serious bacterial infection of the skin. It’s usually caused by streptococci or staphylococci bacteria. Among its symptoms are: 

  • Pain
  • Warmth
  • Redness of the skin that spreads rapidly
  • Swelling 
  • Fever and enlarged lymph nodes in more serious infections

If left untreated, cellulitis can spread quickly throughout your body. The infection can spread to your bloodstream and lymph nodes. Seek emergency care immediately if you have a fever and a red, tender, and swollen rash, or if the rash is changing quickly. 

Cavernous sinus thrombosis. Your cavernous sinuses are located at the base of your brain. The blood from the veins on your face drains into these sinuses. Cavernous sinus thrombosis is a very rare complication when bacteria from facial infections cause a blood clot in your cavernous sinuses. Its symptoms include: 

  • Severe headache
  • Severe pain, especially in the eye area
  • High fever
  • Paralysis or weakness of the eye muscles (ophthalmoplegia)
  • Bulging eye 
  • Swollen eyelid 
  • You may begin to lose feeling in your face
  • Confusion and seizures, which may mean that it has spread to the central nervous system 

Cavernous sinus thrombosis is treated with high doses of intravenous (IV) antibiotics and sometimes corticosteroids.

The underlying infection will also need to be treated. Starting anticoagulant therapy within 7 days of hospitalization may help reduce the risk of death. Anticoagulant drugs will help stop your blood from thickening.

Treatment for Nasal Vestibulitis

Talk to your doctor to work out a suitable treatment for your nasal vestibulitis.

Most cases of nasal vestibulitis can be treated with topical antibiotic creams, such as bacitracin ointment or mupirocin. You may have to use these ointments twice a day for 14 days.

Your doctor may also recommend saline drops or nasal emollients.

If you have boils in your nose, you’ll be prescribed oral antibiotics as well as topical ointments. Your doctor may also recommend that you apply a hot compress three times a day for about 15 to 20 minutes. If the boils don’t go away after taking antibiotics, your doctor may need to surgically drain them. It’s important to treat these boils to prevent further complications.

Acute Bacterial Rhinosinusitis | Cedars-Sinai

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What is acute bacterial rhinosinusitis?

Acute bacterial rhinosinusitis
(ABRS) is an infection of both your nasal cavity and sinuses. It is caused by bacteria.
The nasal cavity is the large air-filled space behind your nose. The sinuses are a
group
of spaces formed by the bones of your face. They connect with your nasal cavity. ABRS
causes the tissue lining these spaces to become inflamed. Mucus may not drain normally.
This leads to face pain and other common symptoms.

It’s more common for rhinosinusitis
to be caused by a virus. But ABRS is caused by bacteria. An acute infection means
that
you’ve had symptoms for less than 4 weeks.

ABRS isn’t as common as acute viral
rhinosinusitis. Women get it more often than men. Middle-aged and older adults also
get
it more often.

What causes acute bacterial rhinosinusitis?

ABRS is caused by bacteria that
infect the lining of your nasal cavity and sinuses. It’s most often caused by the
bacteria Streptococcus pneumonia. Or it may be caused by the bacteria Haemophilus
influenzae. This can happen when the lining is already inflamed. This is often caused
by
a virus. The bacterial infection comes later. It often starts in the nasal cavity
and
spreads into your sinuses.

Other factors can cause
inflammation and make a bacterial infection more likely, such as:

  • Allergies
  • Blockage in the nose
  • Swimming
  • Tooth infection
  • Cocaine use in the nose

What are the symptoms of acute bacterial rhinosinusitis?

The symptoms of ABRS can look like
other health conditions. Symptoms may be different for each person. The symptoms may
include:

  • Face pain or pressure that’s worse
    when leaning forward
  • Postnasal drip
  • Nasal congestion
  • Pain in your upper jaw
  • Toothache in your upper jaw
  • Yellow or greenish discharge from your
    nose
  • Fever
  • Cough
  • Ear pressure or fullness
  • Headache
  • Decreased smell

Most people don’t have all of these
symptoms. With an acute infection, these symptoms have lasted less than 4 weeks.

How is acute bacterial rhinosinusitis diagnosed?

Your healthcare provider will ask
about your health history. He or she will ask about your symptoms and how long you’ve
had them. You may have a physical exam. This is to look for signs of a respiratory
infection.

It’s hard to tell the difference
between viral and bacterial rhinosinusitis. Both have similar symptoms. You may be
more
likely to have ABRS if you’ve had:

  • Symptoms for more than 10 days with no
    improvement
  • A fever of 100.4°F (38.0°C) or
    higher
  • Yellow or greenish nasal
    discharge
  • Pain in the areas around your
    nose
  • Symptoms that suddenly get much worse
    after they seemed to be getting better

In most cases, your provider will
not need to do more tests. They are often not needed, unless you have signs of
complications. You might also need testing if you’ve had several episodes of ABRS.
These
tests might include:

  • Endoscopy of the nasal cavity and sinuses, with and
    without a culture.
    This is done to identify the particular bacteria. And to
    be sure that there are no blockages, such as a foreign body, polyps, or a tumor.
  • CT scan. This provides more information about your
    nasal cavity, sinuses, and related structures.

How is acute bacterial rhinosinusitis treated?

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

Treatments for ABRS can
include:

  • Antibiotics to kill the infecting
    bacteria
  • Pain medicines
  • Rinsing the nasal passages with saline
    to make them feel better

Researchers don’t know if some of
these treatments work for ABRS.

Your healthcare provider may not
give you antibiotics at first. It is hard to tell if you have a bacterial infection.
So
other treatments may be recommended. Antibiotics don’t help rhinosinusitis that is
caused by a virus. Healthcare providers don’t like to give antibiotics if they’re
not
needed. Many people get better without antibiotics.

If your symptoms don’t get better
in several days, you might need antibiotics. If your healthcare provider finds that
you
have a bacterial infection at your first visit, you might get antibiotics right
away.

What are possible complications of acute bacterial
rhinosinusitis?

In rare cases, ABRS may cause
complications such as:

  • Infection of the tissue around the
    brain and spinal cord (meningitis)
  • Infection of the tissue around the eye
    (orbital cellulitis)
  • Infection of the sinus bones
    (osteitis)

Your healthcare provider will keep
track of your symptoms to make sure you don’t have these complications. If you do,
you
might need antibiotics given through an IV (intravenous) line. In very rare cases,
you
might need surgery as well.

When should I call my healthcare provider?

Call your healthcare provider if
your symptoms don’t get better after several days of treatment. Also call right away
if
you have any symptoms of possible complications such as:

  • Swelling around your eyes

Call
911
if you have:

  • Abnormal vision
  • Confusion or loss of alertness

Key points about acute bacterial rhinosinusitis

  • Acute bacterial rhinosinusitis (ABRS)
    is an infection of both your nasal cavity and sinuses. It is caused by bacteria.
  • ABRS sets in when your nasal cavity
    and sinuses first become inflamed from another cause, often a viral infection.
  • You might have symptoms such as face
    pain and fever.
  • You might have yellow or greenish
    discharge from your nose.
  • Your healthcare provider might or
    might not use an antibiotic to help treat you. Other treatments may help make you
    feel better.
  • ABRS rarely causes serious
    complications.

Next steps

Tips to help you get the most from
a visit to your healthcare provider:

  • Know the reason for your visit and
    what you want to happen.
  • Before your visit, write down
    questions you want answered.
  • Bring someone with you to help you ask
    questions and remember what your provider tells you.
  • At the visit, write down the name of a
    new diagnosis, and any new medicines, treatments, or tests. Also write down any new
    instructions your provider gives you.
  • Know why a new medicine or treatment
    is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated
    in other ways.
  • Know why a test or procedure is
    recommended and what the results could mean.
  • Know what to expect if you do not take
    the medicine or have the test or procedure.
  • If you have a follow-up appointment,
    write down the date, time, and purpose for that visit.
  • Know how you can contact your provider
    if you have questions.

Medical Reviewer: Ashutosh Kacker MD

Medical Reviewer: Ronald Karlin MD

Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Cellulitis in Adults: Condition, Treatments, and Pictures – Overview

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Information for
AdultsChildInfantTeen

caption goes here…

Images of Cellulitis

Overview

Cellulitis is an infection of the skin and is most often caused by the bacteria Streptococcus or Staphylococcus. These bacteria are able to enter the skin through small cracks (fissures), causing the sudden appearance of redness, swelling, and warmth in the skin. Cellulitis is sometimes accompanied by fever, chills, and general fatigue.

If the infection is left untreated for too long, cellulitis can result in pockets of pus (abscesses) or the spread of bacteria into the bloodstream (bacteremia). However, most cases of cellulitis resolve with appropriate antibiotic therapy.

Who’s at risk?

Cellulitis can occur in anyone. Factors that increase the risk of developing cellulitis include:

  • Diabetes
  • Lymphedema
  • Skin wounds
  • Chronic lower leg swelling (edema)
  • Athlete’s foot (tinea pedis)
  • Bites from insects, animals, or other humans
  • Obesity
  • Poor circulation in the legs (peripheral vascular disease)
  • Weakened immune system due to underlying illness or medication
  • Intravenous drug abuse

Signs and Symptoms

Cellulitis can affect any part of the body, but the most common locations are:

  • Lower legs
  • Arms or hands
  • Face

Cellulitis initially appears as pink-to-red minimally inflamed skin. The involved area may rapidly become deeper red, swollen, warm, and tender and increase in size as the infection spreads. Occasionally, red streaks may radiate outward from the cellulitis. Blisters or pus-filled bumps may also be present.

Cellulitis may be accompanied by swollen lymph nodes, fever, chills, and fatigue.

Self-Care Guidelines

If you think you have cellulitis, make an appointment to see your doctor. While you are waiting for the appointment with your physician, you can elevate the involved body part in order to decrease swelling. A cool, clean, moist towel can be applied to the area to decrease pain.

When to Seek Medical Care

If you develop a tender, red, warm, enlarging area on your skin, make an appointment with your physician as soon as possible to get treatment and to avoid complications that may occur if cellulitis is left untreated. If you also have fever and chills, or if the area involves the face, you should go to the emergency room.

If you are currently being treated for a skin infection that has not improved after 2–3 days of antibiotics, return to your doctor. You may need treatment with different medications, or the infection may have spread deeper into your skin.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of “staph” bacteria that is resistant to antibiotics in the penicillin family. This class of antibiotics has been the cornerstone of antibiotic therapy for staph and skin infections for decades. CA-MRSA previously infected only small segments of the population, such as health care workers and persons using injection drugs. However, CA-MRSA is now a common cause of skin infections in the general population. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most CA-MRSA infections can easily be treated with commonly available nonpenicillin antibiotics. Rarely, CA-MRSA can cause a deeper skin infection, which usually requires intravenous (IV) antibiotics to treat the infection. There is an additional strain of MRSA (hospital-acquired MRSA), usually found in health care settings, that is susceptible only to intravenous antibiotics, so admission to the hospital is often needed for effective treatment.

Treatments Your Physician May Prescribe

Your physician will usually be able to easily diagnose cellulitis by examining the affected area. Sometimes your doctor may want to get additional information by ordering blood tests and/or performing a bacterial culture in order to identify the specific bacterium that is causing the cellulitis as well as to test its susceptibility to different antibiotics to help guide treatment decisions.

A bacterial culture involves the following:

  1. Opening a blister or pus-filled bump with a needle, scalpel, or lancet after cleansing the skin.
  2. Rubbing a sterile cotton-tipped applicator across the skin to collect the sample.
  3. Sending the specimen to a laboratory.

Typically, the laboratory will have preliminary results within 48–72 hours if there are many bacteria present. However, the culture may take a full week or more to produce final results. In addition to identifying the type of bacterium that is causing the cellulitis, the laboratory usually performs antibiotic sensitivity testing in order to determine the antibiotics that will be most effective in treating the bacteria.

While waiting for the results from the bacterial culture, your doctor may want to start you on an antibiotic to fight the most common bacteria that cause cellulitis. Once the final culture results have returned, your physician may change the antibiotic you are taking, especially if the infection is not improving.

Mild cases of cellulitis in a healthy person can be treated with oral antibiotic pills. Common antibiotics that are used to treat cellulitis include the following:

  • Dicloxacillin
  • Cephalexin
  • Trimethoprim-sulfamethoxazole
  • Clindamycin
  • Doxycycline
  • Linezolid

Someone who appears to be very sick or who has other chronic illnesses that may complicate their recovery may need to be hospitalized to receive intravenous antibiotics. Common intravenous antibiotics that are used to treat cellulitis include the following:

  • Nafcillin
  • Oxacillin
  • Cefazolin
  • Vancomycin

If your doctor prescribes antibiotics, be sure to take the full course of treatment. In addition to prescribing antibiotics, your doctor will likely want to make sure that your underlying medical problems, if any, are being adequately managed.

Trusted Links

MedlinePlus: CellulitisClinical Information and Differential Diagnosis of Cellulitis

References

AN, Swartz MN, Johnson RA. Soft-tissue infections: Erysipelas, Cellulitis, Gangrenous Cellulitis, and Myonecrosis. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, eds. Fitzpatrick’s Dermatology in General Medicine. 7th ed. New York, NY: McGraw-Hill; 2008:1720-1731.

Bolognia, Jean L., ed. Dermatology, pp.1123-1124. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed, pp. 1845, 1848, 1883. New York: McGraw-Hill, 2003.

Necrotizing Fasciitis of the Nose Complicated with Cavernous Sinus Thrombosis

Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative.

1. Introduction

Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia [1]. The trunk and extremities are the most common sites of infection but rarely face and neck regions can be involved; due to its rarity, involvement of the face requires a high level of clinical suspicion. Early diagnosis and aggressive surgical intervention coupled with systemic antibiotic treatment are essential for better outcome and decreased mortality [1]. When the face is included, these interventions might prevent complications such as meningitis and cavernous sinus thrombosis. In this case report we present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis.

2. Case Presentation

The patient is a 42-year-old male with past medical history of systemic hypertension and depression, complaining of facial swelling and fever for two days. The facial swelling started after he pulled “a hair” from his left nostril three days before. The swelling progressively worsened, extending to both nostrils and around his eyes. He also complained of constant severe pain in and around his nose, rated 9/10, relieved with analgesics. At an outside facility he had a lumbar puncture and head CT scan performed, started on vancomycin, and then transferred to Texas Tech University Hospital.

On arrival he had a temperature of 103°F (39.4°C) and was awake, alert, and oriented with mild distress secondary to pain. He was complaining of eye swelling, nasal pain, and congestion. Erythema and swelling on his forehead, nose, eyelids, periorbital regions, and perinasal regions were noted. Eye examination revealed intact extraocular muscle and severe chemosis but intact vision with yellowish crust over his eyelids. There was reduced adduction of the right eye in the direction of action of the inferior oblique, but otherwise normal III cranial nerve function. Also, examination of cranial nerves IV, VI, V1 and V2 was normal as was the rest of the eye exam. Severe tenderness was noted on palpation of the nose with erythema and bilateral swelling of the mucus membranes (Figure 1). All other exams were normal.

His cerebral spinal fluid (CSF) results from the previous facility showed a white blood cell count (WBC) of 1,197/mm3, RBC 27/mm3, protein 100 mg/dL, and glucose of 54 mg/dL. Initial labs revealed a peripheral blood WBC of 24,000/uL with a predominance of neutrophils (85%). The CT scan of the maxillofacial area showed a fluid collection with multiple small air loculi in the anterior nasal cavity as well as evidence of possible osteomyelitis of nasal septum and a component of acute sinusitis in right frontal sinus. Ear, nose, and throat (ENT) surgery, infectious diseases (ID), neurosurgery, and neurology were consulted and the patient was started on empirical antibiotic (vancomycin and ceftriaxone).

Incision and drainage of the septal abscess with washout and debridement of the nasal septum using nasal endoscopy were performed; tissue necrosis was noted during the procedure. ID replaced the ceftriaxone with clindamycin (for possible toxin production) and meropenem for broader gram-negative and anaerobe coverage.

Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) (Figures 2-3) studies demonstrated concerns for cavernous sinus thrombosis. A MRI with contrast failed to reveal filling defect of the cavernous sinus but noted mild proptosis of the right orbit and dilatation of the right superior ophthalmic vein, suggestive secondary signs of right cavernous sinus thrombosis.


Prior to discharge he had improving mild right-sided ptosis but was otherwise asymptomatic and afebrile. As per neurosurgery and neurology recommendations, no anticoagulation was needed for the cavernous sinus thrombosis. His final incision and drainage cultures were positive for methicillin resistant Staphylococcus aureus (MRSA) with a vancomycin minimum inhibitory concentration (MIC) equal to 2.0. His antibiotics were changed to IV daptomycin for 6 weeks as per infectious diseases recommendations. He continued to receive irrigation of the nares with gentamicin and vancomycin as per ENT surgery’s recommendations. He was discharged on IV daptomycin only and followed up by surgery in the outpatient clinic. There were no neurological deficits or recurrent infection during the 2-month follow-up period.

3. Discussion

Skin and soft tissue infections (SSTIs) account for more than 14 million outpatient visits in USA each year. Not only the outpatient visit has increased but also hospital admissions for SSTIs increased by 29% from 2000 to 2004 [1]. Necrotizing fasciitis is a well-known complication of untreated and poorly treated cellulitis of skin and soft tissue infection. Necrotizing infections warrant prompt aggressive surgical debridement.

Strongly suggestive clinical signs include bullae, crepitus, gas on radiography, hypotension with systolic blood pressure less than 90 mm Hg, or skin necrosis [1]. As in our case the patient was hypotensive on initial presentation with necrosis noted during endoscopy, a characteristic finding of the necrotizing fasciitis. These are late findings, seen in fewer than 50% of cases. Most cases of necrotizing fasciitis have a false admission diagnosis of cellulitis.

The cavernous sinus receives drainage from cortical and deep cerebral veins and also from the sinus systems of the meninges, scalp, and nasal sinuses, facilitating the spread of infection and/or thrombosis between these vessels. Conversely, a French study of 62 adults with isolated lateral sinus thrombosis found that only 3 cases were related to parameningeal infections [2]. Cavernous sinus thrombosis is an uncommon condition with a varied and often dramatic clinical presentation [3]. These clinical presentations are due to sinus obstruction and impairment of the cranial nerves that are run in close proximity to cavernous sinus [3].

Headache is the most common symptom, usually preceding fevers, periorbital edema, and cranial nerve signs [4]. Physical examination reveals periorbital edema and chemosis, lateral gaze palsy (isolated cranial nerve VI) [4]. CN VI palsy presents early due to its anatomical location (CN VI lies freely within the cavernous sinus), in contrast to CN III and IV, which lie within the lateral walls of the sinus. Ptosis, mydriasis, and eye muscle weakness from cranial nerve III dysfunction may ensue as the disease progresses [4]. Meningeal signs or systemic signs indicative of sepsis are late findings of the disease. In our patient we noted the periorbital edema, limitation of extraocular movement, signs of sepsis, and diagnostic imaging indicating high suspicion of CVS thrombosis.

The American Heart Association (AHA)/American Stroke Association (ASA) 2011 Scientific Statement recommends imaging of the cerebral sinus system in patients with suspected cerebral sinus thrombosis [5]. When clinically suspected the primary modality of investigation includes CT and MRI of the brain. Conventional venography which has higher sensitivity is not used because of increased concerns of dissemination of infection and thrombus extension in patients with septic thrombophlebitis. Cerebral angiography is reserved for the definitive assessment of intracavernous aneurysms after detection and monitoring by CT or MRI. Gallium scintigraphy has occasionally been used as a confirmatory tool in septic CST, demonstrating increased uptake in the cavernous sinus and affected orbit [5]. Our patient did have orbital venous congestion MRI/MRV findings concerning cavernous sinus thrombosis. However, enlargement of the superior ophthalmic vein with proptosis mostly of the right eye was noted. Also, there was evidence for significant mucoperiosteal thickening and sinus disease involving the sphenoid sinuses, although definite filling defects in the cavernous sinus were not seen in our patient. Diagnosis of necrotizing fasciitis requires high clinical suspicion with supportive laboratory/imaging studies. MRI and CT scanning are the recommended diagnostic imaging modalities.

Immediate empiric antibiotic coverage for facial fasciitis must include gram-positive, gram-negative, and anaerobic bacteria coverage and can be narrowed as cultures and sensitivities become available. Surgical intervention of the primary source of infection, including the nasal septum, nasal sinus, and face, is the primary treatment modality. Necrotizing fasciitis needs surgical debridement and concomitant broad-spectrum antibiotic therapy. Empirical antimicrobial therapy usually depends on the antecedent clinical condition and must include coverage for MRSA. An empirical combination, such as parenteral metronidazole, vancomycin, and ceftriaxone, will achieve reasonable CSF and brain penetration and is likely to be active against S. aureus (including CA-MRSA strains) as well as the usual sinus pathogens [6]. After the initial empirical antibiotics it is important to deescalate antibiotic [6]. Antimicrobial selection can be based on positive cultures which are subsequently obtained from blood or CSF although care should be taken, as sinus infections may be polymicrobial. Duration of parenteral antimicrobial therapy should be at least 4 weeks.

The role of anticoagulation as an adjuvant to antibiotic therapy remains controversial, as risk of intracranial bleeding and benefit in preventing further thrombotic proliferation need to be assessed [7, 8]. The primary goal of therapy with anticoagulation is to prevent thrombus propagation, recanalize occluded sinuses and cerebral veins, and prevent complications of deep vein thrombosis and pulmonary embolism. Immediate anticoagulation is administered with either intrasinus unfractionated heparin or with subcutaneously administered low-molecular weight heparin as a bridge to oral anticoagulation with a vitamin K antagonist. Even though feared complication of anticoagulation is intracranial bleeding, in a retrospective study of 102 cases treated with heparin, there was no significant increase in cerebral hemorrhage even in those with preexisting bleeds at presentation [9]. Anticoagulation has been controversial for treatment of cerebral sinus thrombosis because of the tendency for sinus infarcts to become hemorrhagic even before anticoagulants have been administered [9].

Implication of outcome is as follows. Although a thorough discussion of necrotizing fasciitis or cavernous vein thrombosis is beyond the scope of this report, we present an interesting and life threatening condition [10]. As previously stated, high clinical suspicion for septic cavernous venous thrombosis, immediate surgical drainage, and appropriate empirical antibiotic therapy with broad-spectrum coverage are crucial in improving the outcome. As anticoagulation for sinus thrombosis is still controversial and our patient had a good outcome after antibiotics, he was not put on warfarin therapy.

Cavernous sinus thrombosis as a complication of necrotizing fasciitis of the nose is a rapidly progressive and dangerous condition that requires immediate initiation of intensive treatment, including broad-spectrum antibiotics, surgical drainage of the source of infection, anticoagulants, and possibly steroids [10]. Initial clinical suspicion and early MRI use are necessary for the accurate diagnosis of extension of intracranial complications. This case demonstrates a rare presentation of nasal cellulitis with cavernous sinus thrombosis. The guarded prognosis for septic CST in the antibiotic era may be primarily due to delays in recognition of this condition and delays in initiating treatment, as well as other complications developing concomitantly with septic CST.

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

3 Causes for One-Sided Nose Swelling

Systemic disease

Nose swelling may also be caused by disease, such as:

  • Autoimmune disease: An autoimmune disease occurs when the immune system which usually works to protect you against diseases and infections instead starts to attack the healthy cells that make up your body. Some autoimmune diseases attack the cells that make up your nose and can cause internal swelling along with other symptoms like bleeding, deformity, pain or tenderness, reduced sense of smell and difficulty breathing through the affected side.
  • Allergic disease: People with allergies can also have generalized internal swelling of the nose leading to congestion and difficulty breathing through the affected side, and other symptoms like clear runny discharge from the nose, itchy/watery eyes, and sneezing.

Abnormal cell growth

Sometimes one-sided nose swelling can be caused by the abnormal growth of cells in your nose. Sometimes these growths are non-cancerous, soft, painless swellings called nasal polyps. Other times the cells that grow out of control might form a tumor; several types of tumors can grow in the nose, although nasal tumors are very rare. Polyps and tumors can both lead to nasal blockage and the associated symptoms that occur like congestion and difficulty breathing. Some tumors of the nose can also be associated with bleeding, a decreased ability to smell and sinus infections.

3 conditions of one-sided nose swelling

This list does not constitute medical advice and may not accurately represent what you have.

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Relapsing polychondritis

Relapsing polychondritis is a disorder in which defects develop in cartilage and other tissues throughout the body, including the ears, nose, eyes, joints, and respiratory tract. It is considered a rare condition.

Symptoms vary widely by case, but you may experie..

Nose or sinus tumor

A tumor in the nose or one of the sinuses occurs due to abnormal growth of the cells lining the inside of the nose and sinuses. These tumors are rare and can cause symptoms like congestion or blockage, nose bleeds and sometimes facial pain or swelling.

Rarity: Ultra rare

Top Symptoms: new headache, congestion, vision changes, ear fullness/pressure, ear pain

Symptoms that never occur with nose or sinus tumor: improving congestion

Urgency: Primary care doctor

Staph Infection (Staphylococcus Infection)

Overview

What is a staph infection?

Staphylococcal infection, commonly called staph infection, are caused by a genus of bacteria called Staphylococcus. There are more than 30 strains (types) of Staphylococcus bacteria and the most common human pathogen is Staphylococcus aureus. Doctors prescribe antibiotics to treat staphylococcal infection. In severe cases, staph infection can cause serious health complications and death.

What parts of the body are affected by staph infection?

Different types of staph bacteria cause problems in various parts of the body. Staphylococcal infection can affect the:

  • Skin: Most commonly, Staphylococcus aureus bacteria cause skin infection. This can produce boils, blisters, and redness on the skin.
  • Breasts: Breastfeeding women can develop mastitis, which causes inflammation (swelling) and abscesses (collections of pus) in the breast.
  • Digestive system: When ingested (eaten), the staph bacteria cause food poisoning, leading to vomiting and diarrhea.
  • Bones: The bacteria can infect the bones, causing inflammation and pain. This infection is called osteomyelitis.
  • Lungs and heart: If the bacteria get into the lungs, abscesses can form, causing pneumonia and breathing problems. Staph bacteria can also damage the heart valves and lead to heart failure.
  • Bloodstream: When bacteria release toxins into the body, a serious infection called septicemia (blood poisoning) can occur.

How common is staph infection?

There are millions of skin staph infections in the United States every year. Most of these cases are mild and treated with antibiotics. It is common for the Staphylococcus bacteria to live on the skin or in the nose of healthy people. The bacteria only cause problems when they make their way inside the body. However, there are many thousands of serious cases of S. aureus infection in the United States every year.

Who is affected by staph infection?

While anyone can get a staph infection, certain groups of people are at higher risk than others. People who work in hospitals are more likely to have the bacteria on their skin. Staph infections occur most often in people who:

  • Inject drugs
  • Are hospitalized, have recently had surgery, or have catheters or medical devices in their body
  • Manage a chronic condition like diabetes or vascular disease
  • Have a weakened immune system
  • Are breastfeeding
  • Have worn a tampon for an extended time
  • Have congenital heart defects
  • Have had other surgeries on heart valves

Symptoms and Causes

What are the symptoms of staph infection on the skin?

Symptoms of a staph infection vary depending on the area of the body where the infection occurs. Staph infection occur most often on the skin. Symptoms of staph infection on the skin include:

  • Abscesses and boils: These painful sores form under the skin, causing redness and pain.
  • Cellulitis: This type of infection causes swollen, red, painful skin and tissue just under the skin.
  • Folliculitis: A small pimple-like blister forms under the hair follicle and causes pain.
  • Impetigo: Fluid-filled blisters or sores form and rupture, leaving a yellow or brown crust.
  • Staphylococcal scalded-skin syndrome (SSSS): This serious infection causes skin to peel off all over the body. It usually affects infants and small children.

What are the symptoms of staph infection in the body?

When a staph infection occurs in areas of the body other than the skin, symptoms include:

  • Food poisoning: Symptoms can be severe and include vomiting and diarrhea.
  • Mastitis: Occurring mostly in breastfeeding women, mastitis leads to inflammation, pain, and abscesses in the breast.
  • Septicemia: Staph bacteria in the bloodstream can cause blood poisoning, also called sepsis. Symptoms include fever and dangerously low blood pressure (hypotension).
  • Toxic shock syndrome: A severe form of septicemia, toxic shock syndrome (TSS) symptoms include fever, muscle aches, and a rash that looks like sunburn.
  • Endocarditis: This infection of the lining of the heart muscle is often caused by staph infection. The heart valves and the heart muscle may also be affected. Symptoms include fever, sweating, weight loss, and fast heart rate.

How do people get staph infection?

Staph infection spread in a variety of ways, including:

  • Skin infection: Staph infection on the skin occur when someone comes into contact with the Staphylococcus bacteria. The bacteria are contagious and usually enter into the skin through a cut.
  • Food poisoning: The staph bacteria are ingested (eaten), usually due to cross-contamination when handling food.
  • Toxic shock syndrome: When a woman wears a tampon for an extended time, blood collects on the tampon and creates the ideal environment for bacteria from the woman’s vagina to grow. The bacteria enter into the body through tiny cuts in the lining of the vagina.
  • Mastitis: In breastfeeding women, bacteria from the baby’s mouth enter the breast through a crack in the nipple. When the breast isn’t emptied often, bacteria get trapped in the breast and cause infection.
  • Endocarditis: The bacteria enter the heart through the bloodstream, sometimes through the mouth. People with poor dental health or who bleed when brushing their teeth might be more at risk for this happening.

Diagnosis and Tests

How is staph infection diagnosed?

Your doctor’s diagnosis of a staph infection depends on what area of the body is affected.

  • Skin: Usually, doctors diagnose a staph infection on the skin by examining the affected area. Your doctor may choose to take a sample of the skin to test for the bacteria.
  • Food poisoning: Your doctor will ask about the length and severity of your symptoms and may take a stool sample.
  • Mastitis: After considering your symptoms, your doctor may send a sample of your breast milk to a lab to test for the presence of bacteria.
  • Toxic shock syndrome: Your doctor may take a urine or blood sample to check for bacteria. Sometimes, doctors will also order a CT scan to see if the infection is affecting the organs.
  • Endocarditis: Diagnosis is based on symptoms, blood tests, and an echocardiogram.

How do I know if I have staph infection?

If you have symptoms of a staph infection, you should contact your doctor for diagnosis and treatment. See your doctor if you or your child has an area of skin that is blistered, irritated, or red, especially if a fever accompanies these symptoms. Only a doctor can diagnose and treat a staph infection.

Management and Treatment

What are the treatments for staph infection?

Most staph infection on the skin can be treated with a topical antibiotic (applied to the skin). Your doctor may also drain a boil or abscess by making a small incision to let the pus out.

Doctors also prescribe oral antibiotics (taken by mouth) to treat staph infection in the body and on the skin. The antibiotic will vary depending on the type of infection. In severe cases of staph infection, doctors use IV (intravenous) antibiotics to kill the bacteria.

What are the side effects of the treatment for staph infection?

Side effects vary depending on the type of antibiotic used to treat the staph infection. Side effects from topical ointments can include stinging, itching, and redness in the affected area. Common side effects of oral antibiotics include nausea, vomiting, and diarrhea.

What are the complications associated with staph infection?

If left untreated, staph infection can be deadly. Rarely, staph infection are resistant to the antibiotics commonly used to treat them. This infection, called methicillin-resistant Staphylococcus aureus (MRSA), cause severe infection and death.

What can I do to help relieve symptoms of staph infection?

It is important to see your doctor if you think you might have a staph infection. To relieve the symptoms of staph infection on the skin, you should clean the affected area with soap and water. Cold compresses and over-the-counter pain relievers may ease the discomfort of skin infection.

In cases of food poisoning, drink plenty of liquids while you are recovering to reduce your risk of dehydration. Massage and warm compresses can relieve the symptoms of mastitis.

Prevention

How can I prevent staph infection?

Prevention depends on the type of infection. To reduce your risk of a staph infection, you should follow these tips:

  • Skin: To prevent a staph infection of the skin, you should practice good hygiene, keep cuts clean, and wash your hands and body often. Avoid sharing towels and personal items with others.
  • Food poisoning: You can reduce your risk of food poisoning by handling food safely, ensuring that it is cooked properly, and refrigerating perishable food within 2 hours.
  • Toxic shock syndrome: You should change tampons every 4 to 8 hours and use tampons with the lowest effective absorbency.
  • Mastitis: Breastfeeding women should try to empty the breast completely during every feeding. Whenever possible, let nipples air dry.

Outlook / Prognosis

What is the outlook for people who have staph infection?

Most staph infections of the skin are mild. They can be treated with antibiotics and have no lasting effects.

When staph infections are left untreated, they can lead to organ failure and death. In rare cases, methicillin-resistant Staphylococcus aureus (MRSA) infection can be deadly if the infection isn’t controlled.

Living With

When should I call my doctor about staph infection?

Since staph infection can become serious very quickly, you should contact your doctor right away if you have signs of a staph infection. Only a doctor can diagnose and treat a staph infection.

Nasal Cellulitis – How To Recognize And Cure

 

What Is Nasal Cellulitis?

Cellulitis literally means inflammation of the cells. Cellulitis affects the tissue just below the surface of the skin. Cellulitis can affect any part of the body and nasal cellulitis refers to the inflammation of cells in the nose. It is contagious. Moreover, if left untreated, the veins inside the nose can lead the infection to the brain that may cause severe life threatening medical conditions. Although, death is very rare, it should not be ruled out.

What Are The Common Causes?

It is caused by bacteria. There are several types of bacteria that cause cellulitis, but staphylococcus and streptococcus are the most common bacteria that cause cellulitis in the nasal region. The bacteria are already present in the skin. These bacteria generally do not cause harm but they tend to grow, multiply and cause infection when there are cuts and abrasions in the skin. Insect bites can start the infection.

 

About Risk Factors

1. Injuries, cuts, insect bites and scrapes increase the chances of getting cellulitis in the nasal area.
2. A person who has a history of nose cellulitis is at the risk of getting it repeatedly.
3. Poor immunity is another risk factor for nasal cellulitis.
4. Infection in the nose.
5. Nose picking is one of the important risk factors in children.
6. Excessive nose blowing increases the risk of cellulitis in nose.

 

What Are The Symptoms Of Nasal Cellulitis?

The following are the common symptoms of cellulitis in the nasal area.
1. Redness and swelling of nose.
2. The skin on the nose feels hot to touch.
3. Blisters may occur in the affected area.

Some patients may experience symptoms like:
1. Fever
2. Chills
3. Vomiting
4. Body aches
5. Loss of appetite
6. Headaches
7. Rapid heartbeat, and
8. Decrease in blood pressure.

 

How Is Nasal Cellulitis Diagnosed?

When the above mentioned symptoms are noted, medical attention should be sought immediately. To diagnose the condition, the health care first asks many questions. These questions must be answered correctly. Then he proceeds to have a look at the previous medical history. A thorough physical examination is done. The affected area is examined to see if it is hot to touch, swollen and red. Then blood tests are ordered to confirm the presence of bacteria.

 

What Are The Treatment Options For Nasal Cellulitis?

 

Antibiotics

The treatment begins with antibiotics. The antibiotics prescribed depend upon the severity of the infection. Mild infections do not need to stay in the hospital. In severe cases, antibiotics are administered intravenously in the hospital. As the recurrence of the infection is very common, the antibiotics are generally prescribed for a longer duration of time. The medication should be taken as directed by the doctor. It should not be stopped when the symptoms start to improve.

 

Alternative Treatments

Herbal treatments and Chinese Acupuncture are effective alternative treatment for nasal cellulitis.

What are the home remedies?
1. Foods rich in vitamin C like citrus fruits, guava and papaya etc. Should be included in the diet.
2. Eat a healthy diet to improve the immunity.
3. Garlic, turmeric and onion have antibiotic and antioxidant properties. They should be included in possible recipes.
4. Aloe Vera is helpful in reducing the inflammation.
5. Keep the area clean.

 

How To Prevent Nasal Cellulitis?

1. Protecting the nose from cuts and bruises is the best way to prevent nasal cellulitis.
2. If you get a cut, make sure that you wash it immediately using a disinfectant and apply a topical antibiotic.
3. If they are painful, contact a doctor immediately.

Nasal cellulitis is very common and completely curable if it is taken care of in the early stages.

Image credit: 123RF Photo

90,000 Cellulite – Causes, Symptoms and Treatment

Cellulite (from Lat. Cellula – “cell”) is a change in adipose tissue, specific for women, in which, under the influence of various factors, the lymph and blood supply of fat cells (adipocytes) is disrupted. A synonym for cellulite is the term “lipodystrophy” (literally – a malnutrition of a fat cell), which reflects a malfunction in fat metabolism at the cellular level. The adipose tissue affected by cellulite is excluded from the general fat metabolism. In this case, the connective tissue grows and begins to squeeze and “push” them.As a result, bumps appear on the surface of the skin and the so-called orange peel effect occurs.

The most common cellulite forms on the thighs and buttocks.

Cellulite does not appear immediately, it develops gradually, slowly and imperceptibly. Moreover, it can appear at any age – at eighteen, and at forty, both in overweight and thin women.

How to remove cellulite?

LINLINE anti-cellulite program includes several different procedures and will help get rid of cellulite.

Shockwave therapy for cellulite.

The mechanical force of waves penetrates the tissues of the body and actively affects metabolic processes. As a result of the procedure, the metabolism is accelerated, the process of lipolysis (lipolysis) is started by increasing the circulation of lymph and blood flow in the tissues, fatty deposits are destroyed, and the elasticity of the skin increases. Check the prices for the procedure by calling the clinic in your city or by calling the toll-free number 8-800-7007-911 throughout Russia.

Cellulite treatment with mesotherapy

Mesotherapy is the introduction of special therapeutic cocktails into the skin using injections.Usually a meso-cocktail consists of 2 types of preparations: lipolytic substances (help to break down fatty deposits) and vascular substances (dilate blood vessels, improve blood circulation, metabolism). We have vast experience in mesotherapy and our doctors will select the most effective combination of active ingredients.

We carry out injections only manually (without the use of special guns), this allows a more precise injection of the dose of the drug in the right place. On average, to get rid of cellulite, a course of mesotherapy of 5 procedures is required, the interval between procedures is 7-10 days.

Vacuum massage against cellulite

Dermotonia is a vacuum massage performed on special equipment such as LPG or Skintonic (Le Skin V6). One vacuum massage procedure is equivalent to several conventional anti-cellulite massage. Dermotonia is carried out using a special technique that enhances the effect of lymphatic drainage and relieves circulatory disorders. To get rid of cellulite, you need a course of 10-15 procedures.

Vibration Compression Therapy

Hardware massage stimulates blood circulation and lymph flow due to vibration compression.Special rotating spheres of the device intensively affect the most problematic areas, increasing the temperature of the body surface. Thus, fat deposits are reduced, the skin is tightened and smoothed, and cellulite disappears. For the best effect, it is recommended to undergo a course of procedures.

Massage on the device Beautilizer

A roller, consisting of 72 silicone spheres, is used for the massage. As they rotate, they create compression and microvibration and act on the dermis, adipose tissue and muscle layer.During the session, the metabolism is activated, excess fluid and toxins are removed from the body, the layer of subcutaneous fat decreases, and the skin becomes smooth and elastic. The result is noticeable after the first procedure. To eliminate cellulite, a course of procedures will be required, the effect lasts for at least six months.

Anti-cellulite wraps

The drug is applied to problem areas, after which parts of the body are wrapped in a special film. Anti-cellulite wraps help to reduce the amount of body fat (a good effect even without physical exertion).Course from 5 procedures.

Prices

Anti-cellulite algomineral body wrap VIF. Activates microcirculation, metabolic processes in tissues, promotes elimination of toxins, breakdown of fats and elimination of the “orange peel” effect from 3315 ₽ Sign up

Goodbye Cellulite!

The correct selection of procedures for the anti-cellulite program will make the skin even and smooth, and the cellulite invisible.

Cellulite Treatment – Sign Up for Miseotherapy / Cellulite Injections | Price

PRICE VERY EXTENSIVE. ALL PREPARATIONS CANNOT BE PLACED IN THE CONDITIONS OF ONE SITE!

The problem of cellulite has been known to women for decades, and for the same amount of time they have been trying to find an effective way to deal with it: folk, cosmetic, sports, exhausting diets. Modern medicine is progressing significantly and has already found an excellent method to make women happy.

One of the most effective treatments is cellulite treatment mesotherapy. The so-called “orange peel” disappears due to the injection of drugs under the skin. The drug is chosen individually, taking into account the characteristics of the organism and the stage of progression of the problem. It can be either pure material or a cocktail (mix of hyaluronic acid, minerals, vitamins, etc.). They start biochemical processes, restoring natural metabolism and breaking down the fat layer.

Stages of progression of the problem

The stages of development of cellulite, as mentioned above, are as follows:

  1. The first stage is the initial changes, in which the interdependence of two factors is seen: circulatory disorders and edema of adipose tissue. Visually, it may appear that you have gained weight.

  2. The second stage in the development of cellulite is the formation of the so-called clusters of fat cells in the fibers of the epidermis.To understand if you have such a problem can be very simple: squeeze the skin. But it is important to know that at the same time one person may have different stages of its manifestation in many zones.

  3. Orange peel symptom. In this case, the manifestations of the problem are more obvious and are divided into two stages: 3a – visible only while standing and 3b – visible while lying down.

  4. The fourth, last, stage is characterized by painful sensations in adipose tissue, the rapid development of inflammatory processes and impaired blood circulation.

Effective treatment of the “orange peel” in Kiev

Slimming injections and their number depend on what stage you are in. But one cannot but say about the indisputable benefits of mesotherapy for cellulite:

  • Efficiency.

  • Long lasting and stable result.

  • The possibility of using drugs both in pure form and in cocktails.

  • The versatility of the method.

Cellulite treatment is sometimes a lengthy process that also requires compliance with certain requirements. For example, a ban on taking anticoagulants three days before injections, drinking alcohol on the day of the procedure. But after you have received injections for cellulite, you cannot visit the pool, sauna, bathhouse for a while.

If you are faced with this problem, which causes unpleasant and even painful sensations, contact our beauty salon Dr.Shinder & Beauty Space, where cellulite treatment is carried out in Kiev.

90,000 What is nasal cellulite?

Nasal cellulitis is a skin infection involving the skin on or around the nose. Typically, the end of the nose is involved and turns bright red, in addition to swelling and the development of tenderness and sensitivity. Treatment includes antibiotics to kill the pathogen and may include supportive therapy such as anti-inflammatory drugs and warm compresses to help the patient feel more comfortable. The care can usually be provided by a general practitioner.

Any number of bacteria can be involved in nasal cellulite. People may experience a small cut or scratch in the nose or in the surrounding area. The bacteria will grow in the layers of the skin, eventually causing an infection. Common risk factors can include sports injuries, where people can get injured in a dirty place, giving bacteria time to seize, along with surgery and existing inflammation or infection around the nose.For example, a person with impetigo around the nose may scratch and create a pathway for bacteria to enter and develop cellulite in the nose.

This condition is usually easy to diagnose due to the distinctive appearance of the nose. A broad spectrum antibiotic can be prescribed to kill bacteria. If the patient is not responding, it may be necessary to take a culture to test the bacteria for antibiotic resistance and select a more appropriate drug. Cultures can be taken early in people with weakened immune systems, as they need to be treated aggressively and quickly to prevent complications.

Untreated nasal cellulite can spread. There is a chance that the infection will reach the sinus or the sensitive membranes around the eye. Persistent untreated infections around the face can also potentially reach the brain, which can be extremely dangerous. Patients who notice that their noses appear red and inflamed should see a doctor if there is no pre-existing condition, such as rosacea or poor sunburn, to explain the changes in the nose.

Nose infection from cellulite should not be scarred unless it becomes severe and cracks the skin or if the patient scratches to relieve itching and irritation. People who are worried about scratching or injuring their nose at night may want to wear a bandage to protect their nose. Although the tip of the nose will look unsightly, the use of cosmetics to cover it is not recommended as it can complicate treatment and lead to additional inflammation and irritation, which makes the nose look even worse.

OTHER LANGUAGES

Juvenile cellulite | Veterinary clinic of Dr.

Shubin

Definitions

Juvenile cellulitis is a rare, idiopathic form of panniculitis in young puppies.

Synonyms: juvenile pyoderma, puppy washes, juvenile sterile granulomatous dermatitis and lymphadenitis.

Reasons

The exact cause has not been determined, but it is thought to be a dysfunction of the immune system because the disease responds well to corticosteroid therapy.In view of the identified breed predisposition, a hereditary causal component is likely. Also, vaccine components are considered as a trigger of an immune response.

Clinical signs

The disease manifests itself between 3 weeks and 4 months of age (probably up to 6). The breed predisposition was noted in such breeds as Dachshund, Golden Retriever, Labrador Retriever, Golden Setter, Beagle, Pointer. In one litter, the defeat of one puppy or several can be noted.

The initial lesion is swelling in the muzzle, which is especially pronounced on the eyelids and lips. On physical examination, the submandibular lymph nodes are enlarged. The disease develops acutely, papules and pustules develop within 24-48 hours, which subsequently rupture and crusts form. In the midst of the disease, the characteristic localization of the lesions is the eyelids, lips, nasal bridge, chin, inner surface of the ear canal (otitis media).

Probably abscess formation of the submandibular lymph nodes.Occasionally, the lesions are not limited to the characteristic localization and spread to other parts of the body (usually the trunk). Systemic manifestations such as fever, depression, anorexia, and joint pain are also likely.

Cytological examination of pustules – sterile pyogranulomatous inflammation, microorganisms re-attach in ulceration.

Diagnosis

High probability presumptive diagnosis based on clinical features.

The final diagnosis is dermatohistopathology (pyogranulomatous dermatitis and panniculitis).

Differential diagnosis

• Angioedema (at the onset of the disease).
• Demodectic mange with secondary pyoderma.
• Adverse skin reactions to drugs.
• Pyoderma.

Treatment

Therapy of choice – corticosteroids in immunosuppressive doses. Prednisolone 2 mg / kg / day PO until resolution is resolved (2-4 weeks).Some dogs respond better to dexamethasone therapy. When a secondary infection is attached, antibacterial therapy is performed (cephalexin, amoxicillin clavunate). Topical therapy is rarely used due to the puppies’ significant resistance to topical treatments.

Forecasts

With adequate treatment – the prognosis is favorable, the animal outgrows the disease. In severe cases and with delayed treatment, scarring is likely. Death is likely if left untreated.

Photo 1-2. Characteristic skin lesions in a

Labrador puppy

Photo 2-3. Typical lesions in a 2 month old dachshund puppy at a veterinary clinic. Blepharitis is one of the characteristic features of juvenile cellulite.

Valery Shubin, veterinarian, Balakovo

Orbital cellulitis – causes, symptoms, diagnosis and treatment

Orbital cellulitis (orbital cellulitis) – diffuse purulent inflammation of the orbital tissue.Orbital cellulitis is characterized by a severe general condition (headache, nausea, febrile temperature), throbbing pain in the orbit, exophthalmos, diplopia, edema and hyperemia of the eyelids, conjunctival chemosis, decreased visual acuity, limited mobility of the eyeball. Diagnosis of phlegmon of the orbit involves establishing a connection between the disease and purulent infections (sinusitis, facial furuncles, dacryocystitis, complicated orbital injuries, etc.), radiography, ultrasound, CT of the orbit and paranasal sinuses, orthopantomograms.Treatment requires systemic and local use of antibiotics, opening and drainage of the phlegmon of the orbit.

General

Orbital cellulitis (orbital cellulitis) is a major problem in surgical ophthalmology. Despite its relatively low incidence (about 1% of cases in the population), phlegmon of the orbit can pose a danger not only to visual function, but also to the patient’s life. With the spread of a purulent process along the venous bed from the orbit into the cranial cavity, dangerous complications develop – thrombosis of cerebral vessels and meningitis, which in 20% of cases lead to the death of patients.Orbital cellulitis can occur at any age, but is more common in children under 5 years of age.

Phlegmon of the orbit

Causes of phlegmon of the orbit

The development of phlegmon of the orbit is etiopathogenetically closely related to purulent diseases of the eyes, paranasal sinuses, dento-maxillary system, skin, injuries of the facial skeleton, general infections.

About 70% of cases of phlegmon of the orbit is an orbital complication of sinusitis, especially ethmoiditis. Purulent fusion of orbital tissue can also be caused by the penetration of infection from nearby foci of inflammation: teeth and jaws (with osteomyelitis of the upper jaw, periodontal abscess), facial skin (with furunculosis, erysipelas), eyes (with barley, dacryocystitis, phlegmone of the eyelid, infected complicated by foreign bodies of the eye), etc.e. Less commonly, purulent metastasis in sepsis, complicated by common infections (influenza, scarlet fever, typhoid) is the cause of orbital cellulitis.

Orbital phlegmon, like phlegmon of other localization, in most cases is caused by Staphylococcus aureus and white, hemolytic and greening streptococcus, less often – pneumobacillus, diplococcus, Escherichia coli. Pathogens penetrate into the periorbital tissue through the facial veins and orbital veins, which do not have valves. In this case, small abscesses are formed first, which then merge into large abscesses.

Classification of stages of orbital cellulitis

A purulent process in the orbital tissue develops in stages, passing through the stages of preseptal cellulite, orbital cellulite, subperiosteal abscess and the abscess itself and orbital cellulitis. At the same time, timely therapy can interrupt the further development of inflammation at any stage.

Preseptal cellulite is characterized by inflammatory edema of the tissues of the orbit and eyelids, minor exophthalmos, however, the mobility of the eye at this stage is preserved, and vision is not impaired.Further progression of the infectious process and its spread to the posterior parts of the orbit causes the development of orbital cellulite. This form is clinically manifested by edema of the eyelids, exophthalmos, chemosis, limited mobility of the eyeball and decreased visual acuity. If pus accumulates between the periorbital and the bony wall of the orbit, leading to the destruction of the latter, a subperiosteal abscess of the orbit is formed. At this stage, there is edema and hyperemia of the upper eyelid, impaired mobility and displacement of the eyeball in the direction opposite to the location of the abscess, exophthalmos, impaired visual acuity.

An orbital abscess is characterized by the accumulation of pus in the orbital tissues with the formation of a cavity bounded by the pyogenic membrane. In addition to the above-mentioned signs of purulent orbital inflammation, with an abscess of the orbit, ophthalmoplegia, compression of the optic nerve and blindness can develop. With diffuse inflammation of the orbital tissue, they speak of phlegmon of the orbit.

Symptoms of phlegmon of the orbit

Purulent inflammation with phlegmon of the orbit is usually unilateral and rapid development (from several hours to 1-2 days).At the same time, pulsating pain in the eyelids and orbit sharply arises, which intensifies with movements of the eyeball and palpation. The eyelids are sharply swollen, have a reddish-purple tint, tense, they cannot be opened. As the inflammation grows, infringement of the conjunctiva develops in the palpebral fissure (chemosis), diplopia, exophthalmos, displacement and immobility of the eyeball, a sharp decrease in vision. With phlegmon of the orbit, the general condition of the patient is rapidly deteriorating: malaise, headache, nausea, fever increase.

During the transition of the inflammatory process to the optic nerve, neuritis, thrombotic occlusion of the retinal veins, neuroparalytic keratitis with the formation of a purulent corneal ulcer develops. When involved in purulent inflammation of the vascular and other membranes of the eye, choroiditis and panophthalmitis occur, followed by eye atrophy.

Critical complications of orbital phlegmon can be brain abscess, meningitis, venous sinus thrombosis, sepsis. A relatively favorable outcome of the phlegmon of the orbit can be considered a spontaneous breakthrough of pus through the conjunctiva or the skin of the eyelid to the outside.

Diagnosis of orbital phlegmon

A patient with orbital phlegmon should be consulted immediately by an ophthalmologist, otolaryngologist and dentist. The diagnosis of phlegmon of the orbit is facilitated by the analysis of anamnestic data: the presence of previous purulent processes in the maxillofacial region, a characteristic clinical picture, external examination of the eye with the help of an eyelid lifter, palpation.

Necessary instrumental diagnostics include ultrasound and radiography of the orbit, ultrasound and X-ray examination of the paranasal sinuses, orthopantomogram.For clarifying purposes, diaphanoscopy, ophthalmoscopy to assess the state of the optic nerve, exophthalmometry, biomicroscopy, CT of the orbits, etc. can be used. Of the laboratory tests for phlegmon of the orbit, general clinical blood analysis and blood culture for sterility are of primary diagnostic value.

Orbital phlegmon should be differentiated from eyelid cellulitis, acute dacryocystitis, tenonitis, orbital wall periostitis, orbital foreign body, retrobulbar hemorrhage, glioma, sarcoma, neurofibromatosis, Quincke’s edema.

Treatment of phlegmon of the orbit

With phlegmon of the orbit, urgent hospitalization and immediate initiation of therapy are indicated. Shock doses of broad-spectrum antibiotics and symptomatic agents, detoxification therapy are prescribed. In addition to parenteral administration of antimicrobial drugs, subconjunctival and retrobulbar injections are performed.

At the same time, ethmoidotomy, sinusotomy with trepanation of the orbital wall, puncture and drainage of the paranasal sinus with washing and administration of drugs are performed.In the presence of areas of fluctuation, orbitotomy is performed; the wound canal is drained with a turunda soaked in an antibiotic solution. Subsequently, the incisional cavity is washed with preparations to which the bacterial flora is sensitive.

In addition, with phlegmon of the orbit, instillations of antibacterial drops and fortified solutions into the conjunctival sac are prescribed; if it is possible to open the eyelids – application of ointments to the conjunctiva and cornea. Subsequently, drug therapy is supplemented with physiotherapy – UHF, UFO.

Prediction and prevention of orbital cellulitis

Active treatment undertaken in the initial stages of orbital cellulitis contributes to a favorable outcome of the disease. However, in the long-term period, there may be a limitation of the mobility of the eyeball, secondary strabismus and amblyopia, corneal leucorrhoea, and atrophy of the optic nerve. The progression and spread of purulent infection can lead to panophthalmitis, brain abscesses, meningitis, cavernous sinus thrombosis, and fatal generalized sepsis.

Prevention of phlegmon of the orbit requires timely sanitation of purulent foci of the skin of the face, ENT organs, dentition, eyes. In case of foreign bodies and mechanical damage to the eyes, mandatory antibiotic prophylaxis of infectious complications is necessary.

90,000 Allergic rhinitis in children – Medkrionics

Allergic rhinitis – inflammation of the nasal mucosa due to an allergic reaction .

In case of allergic diseases of the respiratory tract (so-called respiratory allergies) and, in particular, allergic rhinitis, the main route of penetration into the body of allergens is inhalation. However, there are some age-related features of the spectrum of allergens: in young children, the formation of respiratory allergies is more often associated with exposure to food allergens (cow’s milk, vegetable juices, etc.), in preschoolers, household allergens come to the fore. And in older children – plant pollen allergens, such allergic rhinitis manifests itself in spring and summer.

Allergic rhinitis happens :

  • year-round, caused by household allergens, and symptoms worsen in the autumn-winter period, and
  • seasonal, caused by pollen.

One of the main factors predisposing to allergies is hereditary burden of allergic diseases. Also of great importance are: allergic diathesis, artificial feeding, polluted air, repeated and irrationally treated acute respiratory infections, canned food, chronic diseases of the digestive tract, intestinal, skin and mucous membrane dysbiosis.

One of the main factors predisposing to allergies is hereditary burden of allergic diseases.

The clinical picture of allergic rhinitis is characterized by sneezing attacks, abundant discharge of transparent contents from the nose, nasal congestion. The child breathes through the mouth. Itching also appears in the nose, so the child wrinkles his nose, rubs it, as a result of which a transverse fold appears above the tip of the nose. Sometimes a stuffy nose can be the main symptom of allergic rhinitis.

Conjunctivitis, puffiness of the face, dark circles under the eyes, headache, weakness, allergic skin rashes can be noted at the same time.The temperature usually does not rise, although there may be chills. The ENT doctor, upon examination, notes pallor and swelling of the nasal mucosa.

Diagnosis of allergic rhinitis begins with a detailed interview of the patient, important:

  1. Presence of allergic diseases in other family members,
  2. Allergic reactions in the child himself in the past,
  3. Relationship of the onset of exacerbation with the season, time of day, contact with household (cleaning the house), epidermal (playing with animals), pollen (walking in the field, forest during the flowering season) allergens, taking medications, changes in diet.

The next step is an objective examination, which reveals the characteristic signs of allergic rhinitis described above.

For laboratory confirmation of the allergic nature of the common cold, the following tests are used:

  1. Moderate increase in the number of eosinophils in the blood,
  2. Increased level of total IgE in serum,
  3. Increased content of eosinophils in the analysis of nasal contents.

Also, an allergist can prescribe allergological tests on the skin or in vitro (as a rule, for children under 5 years of age, patients with continuously recurrent rhinitis or in the presence of dermatitis) to identify a causative allergen.

Treatment for allergic rhinitis is as follows :

  1. Dissociation with allergen, if known. And also the mode of maximum antigenic sparing, which provides for the improvement of the home environment with household allergies, a hypoallergenic diet – with food. In case of a reaction to plant pollen – a change in the geographical zone during the flowering season of plants that cause allergies, rest near water bodies, at the sea.
  2. Drug treatment includes antihistamines of general and local action, hormonal drugs (only as a last resort, since the safety of their use in children has not been proven).To prevent the development of an allergic reaction to the nasal mucosa, a drug from the group of “mast cell stabilizers” (sodium cromoglycate) is used topically, which restrains the cell from the release of histamine and other substances. With a persistent course of the disease, a drug of the same group (ketotifen) is prescribed inside for a long course (at least 3 months).
  3. An allergist can prescribe a course of specific hyposensitization, the purpose of which is to reduce the activity of the allergy and alleviate the course of the disease.
  4. Phytotherapy with individual competent prescription gives positive results. However, it is not indicated for children with pollen allergies.
  5. Homeopathy is also effective in the treatment of allergic pathology in general and rhinitis in particular.

Prevention with an appropriate family history begins during pregnancy and is reduced to a rational regimen and adherence to a hypoallergenic diet. Long-term breastfeeding, hardening, rational treatment of acute respiratory infections reduces the risk of developing respiratory allergies in a baby.

It is important to note that drug prevention of exacerbations of seasonal rhinitis should be carried out 1-2 months before the expected exacerbation.

Specialists of the Clinic for Cold Treatment Medkryonika recommend unique methods of treating rhinitis using cryotherapy methods. It is especially important that the treatment of rhinitis with cryotherapy gives very stable positive results in a group of patients who had previously been treated with other methods for a long time and unsuccessfully.

Author: pediatrician Maria Savinova

Based on materials from uaua.info

Acute orbital inflammation, orbital cellulite

Orbital cellulite (orbital cellulite, orbital cellulitis) is an inflammation of the tissues behind the orbital septum. The most common cause of orbital cellulitis is infection.

Orbital cellulitis should not be confused with periorbital (preseptal), which means tissue damage in front of the orbital septum.

What is orbital cellulite?

Orbital cellulitis is a dangerous disease, the consequence of which can be loss of vision (in 10% of cases).

In winter, the number of cases of orbital cellulitis increases significantly, due to frequent sinusitis (inflammation of the paranasal sinuses), through which the infection penetrates into the tissues of the orbit.

Orbital cellulitis is generally more common in children than in adults, with the incidence of lesions in boys about twice that in girls. The average age of children diagnosed with orbital cellulite ranges from 7-12 years.

Among adults of different sexes, the incidence of orbital cellulite is approximately the same.

Causes and symptoms of orbital cellulite

The most common cause of orbital cellulitis is a bacterial infection that affects the tissues of the nose through the paranasal sinuses (sinusitis).

In addition, the infection can reach the eye if it is contained in the blood or tissues of the eyelid.

Respiratory infections, sinusitis, eye injuries, ocular and periocular infections are all factors that increase the risk of developing orbital and periorbital cellulitis.

The most common pathogens are staphylococci and streptococci.

Orbital cellulite symptoms include :

– fever;

– malaise;

– pain in the eye;

– loss of vision;

– puffiness in the area of ​​the infected eye;

– redness.

Patient’s condition will deteriorate rapidly if not properly treated.

Diagnosis and treatment of orbital cellulite

Severe edema of the eye, accompanied by redness, pain and loss of vision, is a sufficient basis for a correct diagnosis.In most cases, the patient confirms the presence of sinusitis or upper respiratory tract infections several days or weeks before the first symptoms of eye cellulitis appear.

Treatment for orbital cellulite should begin immediately after diagnosis . Typically, it includes intravenous antibiotics given in a hospital setting. The first signs of improvement should appear within 48 hours after starting therapy.

Along with the intravenous administration of antibiotics, several tests should be done, in particular – analysis and bacterial culture, in order to identify the pathogen and antibiotics to which it is sensitive.

Surgery is necessary if an abscess threatens the patient’s vision or life.