pelvic cellulitis


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par·a·me·tri·tis

(par'ă-me-trī'tis),
Inflammation of the tissue adjacent to the uterus, particularly in the broad ligament.
Synonym(s): pelvic cellulitis
[parametrium + G. -itis, inflammation]

pelvic cellulitis

bacterial infection of the parametrium, occurring after childbirth or spontaneous or therapeutic abortion. It represents an extension of infection via the blood vessels and lymphatics from a primary wound infection in the external genitalia, perineum, vagina, cervix, or uterus. It is characterized by fever, uterine subinvolution, chills and sweats, abdominal pain that spreads laterally, and, if untreated, the formation of a large abscess and signs of peritonitis. It occurs most commonly between the third and the ninth days after delivery or abortion. Treatment includes an antibiotic, bed rest, IV fluids, and drainage of any abscess that forms. Oxytocics may be given to augment involution.

par·a·me·tri·tis

(par'ă-mĕ-trī'tis)
Inflammation of the tissue adjacent to the uterus, particularly in the broad ligament.
Synonym(s): pelvic cellulitis.
[parametrium + G. -itis, inflammation]

cellulitis

(sel?yu-lit'is ) [ cellula + -itis, ]
Enlarge picture
CELLULITIS
A spreading bacterial infection of the skin and subcutaneous tissues, usually caused by streptococcal or staphylococcal infections in adults (and occasionally by Haemophilus species in children). It may occur following damage to skin from an insect bite, an excoriation, or other wound. The extremities, esp. the lower legs, are the most common sites. Adjacent soft tissue may be involved. Affected skin becomes inflamed: red, swollen, warm to the touch, and tender. Spread of infection up lymphatic channels may occur. Cellulitis involving the face is called erysipelas. When it affects the lower extremities, cellulitis must be differentiated from stasis dermatitis, which is associated most commonly with bilateral, chronic dependent edema and, occasionally, with deep venous thrombosis. Risk factors for cellulitis include diabetes mellitus, lymphedema, venous stasis or insufficiency, immune suppression, injection drug use, malnutrition, peripheral vascular disease, and previous skin diseases. See: illustration; necrotizing fasciitis

Etiology

Bacteria gain access through breaks in the skin and spread rapidly, overwhelming normal body defenses; lesions between the toes from athlete's foot are common entry sites.

Treatment

For mild cases of cellulitis, oral antibiotics may be effective depending on the causative organism. For severe cases, intravenous penicillinase-resistant penicillins are used; surgical débridement to obtain cultures and to rule out fasciitis is recommended for patients with diabetes.

CAUTION!

Rarely, group A streptococcal cellulitis may be complicated by exfoliative dermatitis or infection of the subcutaneous fat and fascia, causing necrosis (necrotizing fasciitis), a condition popularly ascribed to the action of “flesh-eating bacteria.”

Patient care

Blood cultures should be obtained from patients with cellulitis to assess for sepsis before beginning therapy with antibiotics. The affected body part should be elevated above the level of the heart. Outlining the affected area with a skin marker allows the caregiver to readily determine if inflamed tissues are responding to therapy. Size, shape, color, and temperature of the affected area and surrounding tissues should be documented and any drainage described. Applying warm soaks to the area increases vasodilation, thus decreasing edema and relieving pain. Pain should be treated with prescribed oral analgesics and anti-inflammatory drugs. Blood sugars, if elevated, should be lowered to normal levels (preferably about 126 mg/dl or less). Patients on prolonged bedrest should be given heparin to prevent deep venous thrombosis as well as stool softeners to prevent constipation. Patients who develop cellulitis are often at risk for recurrence; they should learn general skin hygiene, how to clean cuts, scratches, cracked skin, and abrasions, and the importance of prompt treatment for infections.

dissecting cellulitis of the scalp

An inflammatory pustular disease of the scalp, similar to acne conglobata or hidradenitis suppurativa. It can be treated surgically, with isotretinoin, or with laser therapy. Synonym: perifolliculitis capitis abscedens

eosinophilic cellulitis

A rash marked by firm, swollen, itchy patches that appear suddenly. The patches may be oval or circular, violet or red, and are associated with abnormally high blood eosinophil levels. The cause is unknown.
Synonym: Wells syndrome

orbital cellulitis

Postseptal cellulitis.

pelvic cellulitis

Parametritis.

periorbital cellulitis

Preseptal cellulitis.

postseptal cellulitis

Facial infection invading the orbit. Synonym: orbital cellulitis

preseptal cellulitis

Soft tissue infection limited to the tissues anterior to the orbital septum. Synonym: periorbital cellulitis
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