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Chap. 9 - LIFE-THREATENING BACTERIAL SKIN INFECTIONS

Published online by Cambridge University Press:  07 September 2011

By
Richard B. Cindrich  and
Donald Rudikoff
Edited by
Ronni Wolf ,
Batya B. Davidovici ,
Jennifer L. Parish  and
Lawrence Charles Parish
Richard B. Cindrich
Affiliation:
Albert Einstein College of Medicine
Donald Rudikoff
Affiliation:
Albert Einstein College of Medicine
Ronni Wolf
Affiliation:
Kaplan Medical Center, Rehovot, Israel
Batya B. Davidovici
Affiliation:
Kaplan Medical Center, Rehovot, Israel
Jennifer L. Parish
Affiliation:
Jefferson Medical College of Thomas Jefferson University
Lawrence Charles Parish
Affiliation:
Jefferson Medical College of Thomas Jefferson University
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Summary

DERMATOLOGISTS are often called on to diagnose severe life-threatening skin infections in the emergency department, hospital wards, and in their clinical practices. The observational skills of the dermatologic specialist enable him or her to differentiate conditions that are potentially fatal from those that may look horrific but are not life threatening. This chapter provides essential information on serious infections, many of which are not usually discussed in depth in most dermatologic texts. These include periorbital (preseptal) and orbital cellulitis, malignant external otitis, meningococcemia, Rocky Mountain spotted fever (RMSF), Mediterranean spotted fever, anthrax, tularemia, and infections with Vibrio vulnificus, Aeromonas hydrophila and Chromobacterium violaceum. It is hoped that prompt recognition of these infections by the clinician will reduce morbidity and possibly be lifesaving.

PERIORBITAL (PRESEPTAL) CELLULITIS AND ORBITAL CELLULITIS

Background

Eyelid infections presenting with erythema and edema are not uncommon in children and adults and in some cases can cause serious sequelae. Involvement of the orbit with bacterial infection can result in severe damage to the eye, cavernous sinus thrombosis, and death. Preseptal cellulitis is an infection of the eyelids and surrounding skin anterior to the orbital septum (Figure 9.1). This layer of fibrous tissue arises from the periosteum of the orbit and extends into the eyelids. Infection posterior to the septum is referred to as orbital cellulitis. Although less common than preseptal cellulitis, it is a much more worrisome condition with the potential for major sequelae.

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Emergency Dermatology , pp. 81 - 97
Publisher: Cambridge University Press
Print publication year: 2011

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