PRESEPTAL CELLULITIS. CLINICAL CASE WITH LABORATORY DIAGNOSIS

Cudberto U. Contreras-Pérez, Mónica G. Viveros-Terrazas and José D. Méndez*

ABSTRACT

We present a pediatric case of preseptal cellulitis in a 13-year-old girl with probable hematogenous spread from a primary focus. The diagnosis established by two specialists was acute conjunctivitis. The initial treatment with ampicillin sulbactam did not have a favorable response. Due to the severity of the infection, an empirical treatment was established with lincomycin, an antibiotic that maintains therapeutic plasma concentrations against most Gram+ microorganisms. The scheme was complemented with clindamycin, based on the results of the antibiogram. The combination of the two lincosamides, one injectable (i. m.) and the other oral, showed excellent response and clinical healing was obtained at 12 days. In these patients, an adequate and timely clinical assessment is essential to establish a reliable clinical diagnosis. Laboratory studies are determinant and must be done before starting treatment. The quality of the sample involves a correct microbiological procedure. The culture, identification and antibiogram of the microorganism involved in the lesions, is necessary to continue or modify the treatment. It is important the collaboration between the clinician and the laboratory to keep a good follow-up of these cases, to avoid serious complications and speed up the therapeutic decisions if necessary.

Keywords: Preseptal cellulitis, Staphylococcus aureus, Clindamycin, Lincomycin, Chloramphenicol.