rifampin and Cellulitis

H. influenzae can cause not only meningitis in children but epiglottitis, cellulitis, pneumonia, pericarditis, and bacteremia. It is possible to radically reduce, if not abolish, the spread of this pathogen. But effective prophylaxis requires answers to questions of practicability relative to the availability, cost, and logistics of administering rifampin to contacts, as has been recommended.

Topics: Adolescent; Adult; Carrier State; Cellulitis; Child; Child, Preschool; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Epiglottis; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Meningitis, Haemophilus; Pericarditis; Pneumonia; Pregnancy; Rifampin; Sepsis; Trimethoprim

An 89-year-old man presented with an inflammatory erythematous plaque on the left thigh that closely mimicked cellulitis. Empiric therapies with ordinary antibiotics were not effective. A skin biopsy showed epithelioid cell granulomas throughout the dermis and subcutis. Ziehl-Neelsen stain revealed numerous acid-fast bacilli. Additionally, Mycobacterium tuberculosis was isolated from a skin biopsy specimen as well as gastric fluid and sputum cultures. He was diagnosed with tuberculous cellulitis with pulmonary tuberculosis. Cellulitis is a common disease seen by dermatologists; however, sometimes other diseases may masquerade as this banal illness. Among them, cutaneous tuberculosis should be excluded because of its clinical significance. Most cases of cutaneous tuberculosis are symptom free, but tuberculous cellulitis is sometimes painful. Therefore, cutaneous tuberculosis should always be considered in the differential diagnosis of a cellulitislike rash if the lesions do not respond to ordinary antibiotic therapy, especially in countries with a high incidence of tuberculosis.

Topics: Aged, 80 and over; Antitubercular Agents; Cellulitis; Diagnosis, Differential; Ethambutol; Humans; Isoniazid; Male; Mycobacterium tuberculosis; Rifampin; Skin; Treatment Outcome; Tuberculosis, Cutaneous; Tuberculosis, Pulmonary

Leprosy is a chronic, infectious, systemic disease caused by Mycobacterium leprae and is classified as paucibacillary and multibacillary types. It is contagious and has an insidious onset. Clinical presentation is characterised by hypopigmented skin lesions with reduced sensation. Presence of acid-fast bacilli in tissue specimens is regarded as a gold standard for diagnosis. Treatment is based on multi-drug regimens. We report a case of borderline tuberculoid leprosy in a 31-year-old woman.

Topics: Adult; Cellulitis; Dapsone; Diagnosis, Differential; Facial Dermatoses; Female; Glucocorticoids; Humans; Leprostatic Agents; Leprosy, Borderline; Leprosy, Tuberculoid; Mycobacterium leprae; Prednisolone; Rifampin

Dissecting cellulitis of the scalp, or perifolliculitis capitis abscedens et suffodiens, is an uncommon chronic suppurative disease of the scalp manifested by follicular and perifollicular inflammatory nodules that suppurate and undermine, forming intercommunicating sinuses, and leading to scarring alopecia. Treatment generally fails to obtain a permanently successful result; thus, many therapeutic options have been proposed. We report 4 cases of dissecting cellulitis of the scalp successfully treated with oral rifampicin and oral isotretinoin. To our knowledge, this is the first report of oral rifampicin used concomitantly with oral isotretinoin in this disease entity. We also present a brief review of the literature on the topic.

Topics: Administration, Oral; Adult; Cellulitis; Dermatologic Agents; Diagnosis, Differential; Drug Therapy, Combination; Enzyme Inhibitors; Humans; Isotretinoin; Male; Rifampin; Scalp Dermatoses

Topics: Amoxicillin; Anti-Bacterial Agents; Carrier State; Cellulitis; Disease Outbreaks; Fasciitis, Necrotizing; Humans; Infectious Disease Transmission, Professional-to-Patient; Rifampin; Sclerotherapy; Streptococcus pyogenes; Surgical Wound Infection; Victoria

Topics: Adult; Anti-Bacterial Agents; Cellulitis; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Neutropenia; Phlebitis; Polymyxin B; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin; Treatment Outcome

We report a case of group B streptococcal septicemia of digestive origin with secondary bilateral breast dermal-hypodermal localization.. A 71 year-old woman with a past history of bilateral breast cancer treated by conservation therapy was hospitalized because of the sudden occurrence of two clearly delimited, inflammatory, dermal-hypodermal cutaneous plaques located on each breast, associated with fever (39 degrees C), 4 days after a colonoscopy. Further investigations eliminated carcinomatous mastitis and blood cultures were positive for group B beta-hemolytic streptococcus (Streptococcus agalactiae). Histological examination of a sigmoid polyp revealed a tubular adenocarcinoma.. We report the first documented case of secondary dermal-hypodermal bacterial skin infection (cellulitis) due to group B beta-hemolytic streptococcus. The occurrence after colonoscopy examination, chronology of clinical features, bilaterality and positive blood cultures are arguments in favor of the secondary nature of the skin infection process.

Topics: Adenocarcinoma; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Breast Diseases; Cellulitis; Clavulanic Acid; Colonic Polyps; Colonoscopy; Drug Therapy, Combination; Female; Humans; Metronidazole; Rifampin; Sepsis; Sigmoid Neoplasms; Streptococcal Infections; Streptococcus agalactiae; Time Factors; Treatment Outcome

Topics: Anal Canal; Antibiotics, Antitubercular; Cellulitis; Child; Child, Preschool; Drug Resistance, Bacterial; Genotype; Humans; Male; Microbial Sensitivity Tests; Penicillins; Pharyngitis; Polymerase Chain Reaction; Rifampin; Streptococcal Infections; Streptococcus pyogenes

Topics: Aged; Cellulitis; Drug Therapy, Combination; Ethambutol; Hand; Humans; Male; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Rifampin

Three cases of ecchymotic cellulitis in 7 to 11 month old infants are reported. Haemophilus influenzae was isolated from blood in two cases. Ecchymotic cellulitis in infants should, in the first place, evoke an Haemophilus influenzae infection. Bacteremia being frequent in this condition, blood cultures should be performed.

Topics: Amoxicillin; Ampicillin; Cellulitis; Ecchymosis; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Rifampin

In 1982, an outbreak of Haemophilus influenzae type b disease occurred in a 379-member Amish community. In an attempt to control the outbreak after the occurrence of the second case of disease, we investigated the combination of (1) rifampin chemoprophylaxis of all carriers of H influenzae type b and their household contacts from 1 month to 5 years of age and (2) H influenzae type b polysaccharide vaccine immunoprophylaxis of all community members 12 months of age and older. Despite our intervention, two additional cases of bacteremic H influenzae type b disease occurred in the ensuing 5 months, one in a 22-month-old infant who had been immunized at 19 months of age and the other in a child who had not been immunized because she was younger than 12 months of age. The outbreak ended following rifampin prophylaxis of all community members younger than 15 years of age. All of the children with disease were genetically related to one another, and three of the four were inbred. However, analysis of their coancestry revealed that neither the average level of kinship nor the average inbreeding level of the affected children differed significantly from those of the other children in the community. Furthermore, none of the four children with disease shared a human leukocyte antigen haplotype. Our observations suggest that inbreeding was not a risk factor in this community.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Bacterial Vaccines; Carrier State; Cellulitis; Child; Child, Preschool; Disease Outbreaks; Disease Susceptibility; Ethnicity; Follow-Up Studies; Haemophilus Infections; Haemophilus influenzae; Humans; Immunization; Immunization, Secondary; Infant; Infant, Newborn; Meningitis, Haemophilus; Missouri; Pedigree; Polysaccharides, Bacterial; Rifampin; Rural Population

Based on evidence that patients with infections due to Haemophilus influenzae type b (HIB) remain colonized after therapy, recommendations for chemoprophylaxis of susceptible contacts have included providing rifampin for patients themselves. However, these recommendations have been made with neither definitive advice concerning the timing of rifampin administration nor any supporting data of efficacy and safety in patients. Our data suggest that rifampin given concurrently with therapeutic antimicrobials is as effective-89% (17/19)--as when given following therapeutic antimicrobials-95% (18/19)--in eradicating pharyngeal HIB. Colonization of the pharynx by HIB was also determined before and during therapy. Almost all patients were colonized before beginning therapy; most were heavily colonized. The density of colonization diminished rapidly during the first 15 to 20 hours of therapy. However, 28% of patients, primarily those who had HIB diseases other than meningitis or did not receive any chloramphenicol, still had detectable colonization after four to six days of antimicrobial therapy.

Topics: Cellulitis; Child, Preschool; Epiglottitis; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Meningitis, Haemophilus; Pharyngitis; Rifampin

Three children had staphylococcal infections of the CNS. In two cases the organisms were resistant to methicillin sodium. Each case was treated with a combination of vancomycin hydrochloride and rifampin; in one instance vancomycin alone had been unsuccessful. The addition of rifampin resulted in prompt clinical and bacteriologic resolution. Satisfactory levels of rifampin were achieved by administering the drug either orally or intravenously, and in one patient oral administration of rifampin produced assayed levels in subdural pus many times that required for minimal bactericidal activity. Combination therapy with vancomycin and rifampin is recommended for staphylococcal infections of the CNS.

Topics: Adolescent; Brain Diseases; Cellulitis; Central Nervous System Diseases; Drug Therapy, Combination; Empyema, Subdural; Female; Humans; Infant; Male; Meningitis; Orbital Diseases; Rifampin; Staphylococcal Infections; Vancomycin

Topics: Abscess; Adult; Aged; Arm; Buttocks; Cellulitis; Cheek; Female; Focal Infection, Dental; Foot Diseases; Furunculosis; Hand; Humans; Male; Middle Aged; Osteitis; Piperazines; Rifampin