Abstract
Preseptal cellulitis, an infection of the eyelid and skin around the eye, can be distinguished
from orbital cellulitis. It is common in children and is rarely complicated. Streptococcus pyogenes is one of the major pathogens causing preseptal cellulitis. Here, we report a case
of a 46-year-old man with carcinoma of unknown primary presenting preseptal cellulitis
of S. pyogenes complicated by streptococcal toxic shock syndrome and multiple metastatic abscesses
involving right eyelid, subcutaneous tissue in the scalp, mediastinum, bilateral pleural
spaces, pericardial space, and the left knee. Although he required a prolonged hospitalization,
antibiotic therapy and multiple courses of debridement led to full recovery. A literature
review revealed that there were only four cases of preseptal cellulitis with S. pyogenes in adults and two cases were complicated by streptococcal toxic shock syndrome. The
cases had either trauma or immunocompromising factors similar to our patient. All
patients survived with antibiotic therapy and debridement, and the functional outcome
was favorable. In summary, preseptal cellulitis caused by S. pyogenes can be severe in adult cases where immunocompromising factors and type of strain
may play a role in the severity of the disease. Awareness of the risk of severe complications,
treatment with appropriate antibiotic therapy, and timely debridement are crucial
for favorable prognoses.
Keywords
Abbreviation:
STSS (streptococcal toxic shock syndrome), Spe (streptococcal pyrogenic exotoxin)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 21, 2023
Accepted:
April 4,
2023
Received in revised form:
March 15,
2023
Received:
December 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
