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Elias M, Patel S, Schwartz RA, Lambert WC. The color of skin: red diseases of the skin, nails, and mucosa. Clin Dermatol 2019; 37:548-560. [PMID: 31896409 DOI: 10.1016/j.clindermatol.2019.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Red color is pervasive in local and systemic skin conditions. It is a color that often reflects variations of dermal blood flow and extends beyond the rubor and calor of inflammation. The pathophysiology of red skin involves remote and local chemical mediators that dilate arteriolar smooth muscle and increase blood flow to superficial vessels and capillary beds. Incident light hits hemoglobin, which preferentially absorbs light of shorter wavelengths, such as blue, and reflects warmer colors. Due to its pervasiveness and consistency, red color is a useful descriptive factor in helping narrow a differential diagnosis. Red skin disorders include a variety of conditions involving endocrine mediators, cardiovascular responses, and the disruption of the skin barrier. An understanding of the blood's role in these disorders equips clinicians to generate differential diagnoses through the lens of pathophysiology. Dermatologists can improve management by considering red skin as part of systemic disease rather than as an isolated incident.
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Affiliation(s)
- Marcus Elias
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Shreya Patel
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Robert A Schwartz
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - W Clark Lambert
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
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Chemsi H, Frikh M, Lemnouer A, Belfkih B, Sekhsokh Y, Chadli M, Elouennass M. [Postoperative pulmonary disease associated with haemophilus influenzae and neisseria meningitidis in a diabetic child]. Pan Afr Med J 2016; 25:84. [PMID: 28292047 PMCID: PMC5324154 DOI: 10.11604/pamj.2016.25.84.7290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/30/2015] [Indexed: 11/25/2022] Open
Abstract
Haemophilus influenzae is a saprophyte that colonizes the nasopharynx in nearly two thirds of children and adults. Neisseria meningitidis is a strict human bacterium which lives in the nasopharynx. It can cause benign nasopharyngitis or asymptomatic colonization. We report the case of a diabetic child with postoperative pneumonia associated with Haemophilus influenzae and Neisseria meningitidis. A 3-year old diabetic patient admitted to the Department of Cardiac Surgery due to delayed surgical treatment. The postoperative course was marked by a worsening of respiratory status caused by abundant secretions requiring patient admission to the intensive care unit. An assessment for the detection of infections was performed, including protected distal sampling which revealed the association of Neisseria meningitidis with Haemophilus influenzae. This case study allowed us to highlight bacterial associations in certain high-risk situations. Each of these two species is responsible for various infections. However their presence in the same infected site is rare.
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Affiliation(s)
- Hicham Chemsi
- Laboratoire de Bactériologie de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Rabat, Maroc
| | - Mohamed Frikh
- Laboratoire de Bactériologie de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Rabat, Maroc; Equipe de Recherche Epidémiologie et Résistance Bactérienne, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V-Souissi, Rabat, Maroc
| | - Abdelhay Lemnouer
- Laboratoire de Bactériologie de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Rabat, Maroc; Equipe de Recherche Epidémiologie et Résistance Bactérienne, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V-Souissi, Rabat, Maroc
| | - Bouchra Belfkih
- Laboratoire de Bactériologie de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Rabat, Maroc
| | - Yassine Sekhsokh
- Laboratoire de Recherche et de Biosécurité de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V-Souissi, Rabat, Maroc
| | - Maryama Chadli
- Laboratoire de Bactériologie de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Rabat, Maroc
| | - Mustapha Elouennass
- Laboratoire de Bactériologie de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Rabat, Maroc; Equipe de Recherche Epidémiologie et Résistance Bactérienne, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V-Souissi, Rabat, Maroc
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Barakat MT, Gajurel K, Fischer K, Stevens K, Ozdalga E, Montoya JG. A Case of Meningococcal Pyomyositis in an Otherwise Healthy Adult. Open Forum Infect Dis 2016; 3:ofw087. [PMID: 27703989 PMCID: PMC5047391 DOI: 10.1093/ofid/ofw087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/29/2016] [Indexed: 11/21/2022] Open
Abstract
The clinical spectrum of Neisseria meningitidis can range from nasopharyngeal colonization to life-threatening invasive diseases such as meningitis. However, its etiologic role in invasive pyomyositis (PM) has never been reported before in the English language. In this study, we report the first case of PM in the English language and the second case in the literature caused by N meningitidis.
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Affiliation(s)
| | - Kiran Gajurel
- Division of Infectious Disease & Geographic Medicine
| | | | | | | | - José G Montoya
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine; Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California
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Bethea J, Makki S, Gray S, MacGregor V, Ladhani S. Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013. Euro Surveill 2016; 21:30259. [DOI: 10.2807/1560-7917.es.2016.21.24.30259] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 02/15/2016] [Indexed: 11/20/2022] Open
Abstract
In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts.
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Affiliation(s)
- Jane Bethea
- Centre for Medicine, Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, The University of Leicester, Leicester, United Kingdom
| | - Sophia Makki
- Public Health England East Midlands, Nottingham, United Kingdom
| | - Steve Gray
- Public Health England, Manchester, United Kingdom
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Ozaki B, Kittai A, Chang S. Neisseria meningitidis as a cause of facial cellulitis. BMJ Case Rep 2014; 2014:bcr-2014-203774. [PMID: 24626385 DOI: 10.1136/bcr-2014-203774] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 68-year-old man presented with facial cellulitis and found to have Neisseria meningitidis bacteraemia with no evidence of infection outside of the facial soft tissue. He was treated with a course of intravenous ceftriaxone and transitioned to oral amoxicillin on discharge with significant improvement of his symptoms. N meningitidis is best recognised as a causal agent of bacterial meningitis. To our knowledge N meningitidis cellulitis has only been described in 12 other cases. In this case series we describe and summarise our case, along with the 12 cases already reported in the literature. We report this case series to highlight the importance of recognising N meningitidis in the differential in patients presenting with acute skin and soft tissue infections especially involving the periorbital, head and neck regions.
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Affiliation(s)
- Brent Ozaki
- The George Washington University, Washington, DC, USA
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Carrascosa MF, Casuso-Sáenz E, Salcines-Caviedes JR. Neisseria meningitidis cellulitis. Int J Infect Dis 2012; 16:e760. [PMID: 22727693 DOI: 10.1016/j.ijid.2012.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 04/19/2012] [Indexed: 11/24/2022] Open
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Gupta R, Levent F, Healy CM, Edwards MS. Unusual soft tissue manifestations of Neisseria meningitidis infections. Clin Pediatr (Phila) 2008; 47:400-3. [PMID: 18424564 DOI: 10.1177/0009922807310248] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Soft tissue involvement is an unusual presenting feature for children with meningococcal infection. We describe 2 children, 1 with conjunctivitis and another with a thyroglossal duct cyst abscess associated with Neisseria meningitidis, and review previous reports of these entities to emphasize the broad spectrum of meningococcal disease and pertinent aspects of treatment and of prophylaxis of contacts.
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Affiliation(s)
- Ruchi Gupta
- Driscoll Children's Hospital, Corpus Christi
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Kortepeter MG, Adams BL, Zollinger WD, Gasser RA. Fulminant supraglottitis from Neisseria meningitidis. Emerg Infect Dis 2007; 13:502-4. [PMID: 17552114 PMCID: PMC2725902 DOI: 10.3201/eid1303.061420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - Brian L. Adams
- Madigan Army Medical Center, Fort Lewis, Washington, USA
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Kennedy KJ, Roy J, Lamberth P. Invasive meningococcal disease presenting with cellulitis. Med J Aust 2006; 184:421. [PMID: 16618247 DOI: 10.5694/j.1326-5377.2006.tb00300.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2006] [Accepted: 03/15/2006] [Indexed: 11/17/2022]
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Chand DV, Hoyen CK, Leonard EG, McComsey GA. First reported case of Neisseria meningitidis periorbital cellulitis associated with meningitis. Pediatrics 2005; 116:e874-5. [PMID: 16322145 DOI: 10.1542/peds.2005-0694] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cellulitis is a rare manifestation of meningococcal disease. We describe the case of a previously healthy 4-month-old female infant who developed periorbital cellulitis associated with meningococcal meningitis.
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Affiliation(s)
- David V Chand
- Division of Pediatric Infectious Diseases and Rheumatology, Department of Pediatrics, Rainbow Babies & Children's Hospital, Cleveland, Ohio 44106, USA
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Guignard S, Manceron V, Pouchot J, Mortier E, Vinceneux P. [Extra-meningeal meningococcal infection: report of 14 cases]. Rev Med Interne 2004; 25:3-7. [PMID: 14736555 DOI: 10.1016/s0248-8663(03)00255-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND METHOD Fifty-five patients (17 adults, 38 children) with meningococcal infection were admitted between 1986 and 2002 in a university hospital (500 beds). Fourteen of them (nine adults, five children) presented with an extra-meningeal infection. We compared adults and children presentations. RESULTS All adults had immunodeficiency. Septic locations were various (three bacteriemia, four pneumoniae, one infected ascitis, one cutaneous abscess). All patients received amoxicillin or third generation cephalosporin. Hospitalisation was prolonged (mean: 47 days). Seven patients required intensive care unit admission, and two of them died. All children (all were less than 36-month-old) presented with fever. Only one was immunodeficient (infected by human immunodeficiency virus). Neisseria meningitidis grew from blood in four, and in the throat for the remaining one. Hospitalisation was of short duration (mean: 4 days) and none of the children required intensive care unit. All the children recovered rapidly with antibiotics. CONCLUSION Outcome of extra-meningeal infection with N. meningitidis is different in adults and children. Adults present with immunodeficiency, infection is severe and patients present with various clinical features; children have a more homogeneous clinical presentation (fever) and outcome is excellent.
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Affiliation(s)
- S Guignard
- Service de médecine interne V, hôpital Louis-Mourier, 178, rue des Renouillers, 92700 Colombes, France.
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Cartolano GL, Barbier C, Arnoult L, Simon D, Ricome JL, Hayon J. Fatal acute cellulitis due to Neisseria meningitidis. J Clin Microbiol 2003; 41:3996-7. [PMID: 12904440 PMCID: PMC179831 DOI: 10.1128/jcm.41.8.3996-3997.2003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe the first fatal evolution of cellulitis due to Neisseria meningitidis serogroup Y involving an 85-year-old woman. She presented with an extensive cellulitis of the left side of the face, neck, and thorax and septic shock. In spite of active antibiotic therapy, evolution was rapidly fatal.
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Affiliation(s)
- Gian-Luigi Cartolano
- Department of Microbiology, CHI Poissy-Saint-Germain-en-Laye, 78105 Saint-Germain-en-Laye, France.
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