Baker R C, Bausher J C
Pediatr Infect Dis. 1986 Jul-Aug;5(4):421-3. doi: 10.1097/00006454-198607000-00008.
Eighty cases of acute bacteremic facial cellulitis, 34 buccal and 46 preseptal, were reviewed from the years 1977 through 1982. The epidemiology, clinical presentation, laboratory parameters and course of cellulitis in these two locations were similar. The white blood cell count was over 15,000 in three-fourths of the patients. Haemophilus influenzae type b was cultured from the blood of 67 patients, Streptococcus pneumoniae from 12 and Streptococcus pyogenes from 1. Seven patients had culture-proved meningitis, six with H. influenzae type b and one with S. pneumoniae. Five of these patients had sparse clinical evidence of meningitis, and three of these had meningitis apparent by culture only. We conclude that meningitis may occur in association with acute bacteremic facial cellulitis and may be inapparent both clinically and by initial laboratory examination. We suggest aggressive initial evaluation and treatment of these infants pending culture results.
回顾了1977年至1982年间80例急性菌血症性面部蜂窝织炎病例，其中颊部34例，眶隔前46例。这两个部位蜂窝织炎的流行病学、临床表现、实验室指标及病程相似。四分之三的患者白细胞计数超过15,000。67例患者血培养出b型流感嗜血杆菌，12例培养出肺炎链球菌，1例培养出化脓性链球菌。7例患者培养证实患有脑膜炎，6例为b型流感嗜血杆菌，1例为肺炎链球菌。其中5例患者脑膜炎的临床证据较少，3例仅通过培养显示患有脑膜炎。我们得出结论，脑膜炎可能与急性菌血症性面部蜂窝织炎相关，在临床和初始实验室检查中可能均不明显。我们建议在培养结果出来之前，对这些婴儿进行积极的初始评估和治疗。
