exudates and Cellulitis

Brucellosis is a zoonotic disease with variable clinical manifestations and atypical presentation in humans. Human brucellosis cases are not seen often in Malaysia.. This is a case report of 19 years old gentleman who presented with fever, lower limb redness, pain and swelling. He was initially treated as cellulitis. However, based on the recovery of Brucella melitensis from his blood culture, he was later diagnosed to have brucellosis. He had a history of consumption of fresh goat's milk and uncooked meat which could have been the possible modes of transmission. Brucella serology IgM and IgG were both positive, and anti-Brucella immunocapture agglutination test (BrucellaCapt) was also positive with a titer of 1:2560. He was treated with six weeks of oral doxycycline 100 mg twice daily and oral rifampin 450 mg twice daily.. This is a case of human brucellosis with atypical cutaneous involvement.

Topics: Adult; Agglutination Tests; Antibodies, Bacterial; Brucella melitensis; Brucellosis; Cellulitis; Humans; Malaysia; Male; Young Adult

Cellulitis commonly involved lower limbs. This study was carried out to determine the demography, clinical characteristics, risk factors, microbiological aspects, and antibiotics usage in this group of patients in Hospital Kuala Lumpur.. A total of one hundred and twenty four patients with lower limb cellulitis treated in the Department of Dermatology, Hospital Kuala Lumpur, between January 2008 and May 2013 were included in this study.. There were 70 male and 54 female patients, aged between 13 and 87 years (mean 57.23±12.854). Thirty-one of them (25%) had recurrent cellulitis. Fifty-seven (46%) had fever at presentation, 55 (44.4%) had bullous cellulitis. The top risk factors identified were toe web intertrigo (n = 79, 63.7%), hypertension (n=76, 61.3%), obesity (n = 55, 44.4%), and diabetes (n = 55, 44.4%). However, only toe web intertrigo (p = 0.003), peripheral vascular disease (p = 0.01), and varicose veins (p = 0.02) were significantly higher in recurrent cellulitis. Thirty patients (24.2%) were complicated with lipodermatosclerosis, and six (4.8%) had lymphostasis verrucosa cutis. Skin swab cultures were positive in 54 (43.5%) patients, and Pseudomonas sp. was the most frequently identified organism. Mean number of antibiotics given for one episode of cellulitis was 1.7±1. The antibiotics most given were cloxacillin (n=57, 46%) and other penicillins (n = 71, 57%), followed by cephalosporins (n = 40, 32%).. Identifying clinical characteristics of those at risk may help to prevent recurrence of cellulitis and long-term complications.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cellulitis; Cohort Studies; Female; Follow-Up Studies; Hospitals, Urban; Humans; Lower Extremity; Malaysia; Male; Microbial Sensitivity Tests; Middle Aged; Recurrence; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Factors; Treatment Outcome; Young Adult

An 11-year-old girl presented with multiple blisters on her the right foot complicated with cellulitis. The conventional and molecular identification were performed on the culture. The internal transcribed spacer (ITS) region in rRNA gene of the isolate was amplified by PCR. The sequence of the amplified ITS region matched 99 % with that of Chaetomium globosum in the GenBank. This is the first report describing C. globosum causing cutaneous infection in Malaysia.

Topics: Base Sequence; Cellulitis; Chaetomium; Child; Dermatomycoses; DNA, Fungal; DNA, Ribosomal Spacer; Female; Humans; Malaysia; Microbiological Techniques; Microscopy; Molecular Diagnostic Techniques; Molecular Sequence Data; Sequence Analysis, DNA; Sequence Homology, Nucleic Acid

Melioidosis is endemic in Malaysia. Cutaneous melioidosis is one manifestation and it may progress to necrotizing fasciitis. The case highlights a 46-year-old male, a chicken-seller who presented with scalp cellulitis which later progressed to necrotizing fasciitis and pneumonia are presented here. It illustrates several key features of the presentation, prompt laboratory diagnosis and early treatment of melioidosis which saved the patient's life.

Topics: Animals; Cellulitis; Chickens; Endemic Diseases; Fasciitis, Necrotizing; Humans; Malaysia; Male; Melioidosis; Middle Aged; Occupational Diseases; Pneumonia, Bacterial; Poultry Diseases; Risk Factors