Question

Patient is a 10-year-old male ,good health. Felt pain in his left calf at lunchtime despite not being injured.

Ingrown hair in the location of the pain. That evening small amount of pus from the ingrown hair.

Next morning, found cellulitis on the calf and more pus. By the afternoon, the area of the cellulitis had grown significantly and the patient rushed to the medical center.

Vital signs measured, including pulse, respiration, blood pressure and temperature. All the signs were within the normal limits.

Physical examination of calf, which was red and warm to the touch but with no area of obvious fluctuance. No lymphadenopathy was observed. The physician punctured the central area of the cellulitis, near the area that the patient indicated was the ingrown hair, three times with a 20-gauge needle but no pus was drained. The patient was referred to surgery service and the surgeon gave him 2 g of ceftriaxone intramuscularly and started him on oral cephalexin. The patient returned to the medical center 48h later with obvious area of fluctuance in the centre of the cellulitis area and reported low-grade fever during the past 48 hours. It was obvious that pus is present.

Which factors from the case description have to be taken into consideration when analysing the case?

Answer 1

An Ingrown hair occurs when a shaped or tweezed hair grows back into the skin. It can cause inflammation, pain, tiny bumps in the area where the hair was removed. Having tightly curled hair is the main risk factor for ingrown hairs.

Cellulitis is a severe bacterial infection in the deeper layer of skin. A person with severly infected rajor burn or ingrown hairs can get cellulitis.The affected skin is usually warm and red, and it may feel swollen.

Some cases of cellulitis can result in an abscess forming near the site of infection. An abscess is a swollen , pus filled lump under the surface of skin.

Risk factors for development of Cellulitis and/or skin abscess include skin barrier disruption, edema , venous insufficiency and immunosuppression. So these factors from the description have to be taken into consideration when analysing the case.