Infection and panniculitis

Abstract

Infection-induced panniculitis may result from a number of microbes including bacteria, fungi, and parasites. Viruses have also been implicated as a cause. This type of panniculitis can occur as a primary infection by direct inoculation of infectious microorganisms into the subcutaneous tissue, or secondarily via microbial hematogenous dissemination with subsequent infection of the subcutaneous tissue. Panniculitis is rarely viewed solely in terms of infectious causes. Also, subcutaneous infections are infrequently viewed in terms of infection-induced panniculitis but rather as cutaneous infections with subcutaneous involvement. Little information exists specifically on the subject of infection-induced panniculitis outside of the realm of case reports and case series. In this review, the present authors address panniculitis from the vantage point of infectious causes, focusing on those microorganisms with infection-induced panniculitis reports in the literature. Diagnosis and treatment are also discussed.

Locoregional Multiple Nodular Panniculitis Induced byPseudomonas aeruginosaWithout Septicemia

“…However, bacterial panniculitis manifests as suppurative panniculitis, whereas granulomatous patterns are mostly reported with Mycobacterium species, fungi, and parasites. 15 The overall systemic immunocompetent status of the 6 reported cases could explain the locoregional limitation of the infectious process. The general systemic predisposing factors appear to be advanced age, type 1 or 2 diabetes mellitus, chronic heart disease, and overweight.…”

Skin and subcutaneous fat morphology alterations under the LED or laser treatment in rats in vivo

“…As a possible complication of the proposed photonic fat reduction technique, we may expect some inflammation reaction such as panniculitis that is a progressive lesion of subcutaneous fat tissue of inflammatory nature . However, usually it has an infectious origin, leading to the destruction of fat cells and their replacement by a connective tissue with the formation of nodes, plaques or infiltrates and is accompanied by further damage to the superficial skin layers.…”

Panniculitides of particular interest to the rheumatologist

“…Other locations of involvement are possible such as the upper extremities, the gluteal region and the abdominal wall. However, the clinical picture can vary from infiltrated nodules with discharge or not to necrotizing ulcers depending on the organism involved, the route of infection, the host immune response, and the duration of the lesion at the time of biopsy [72,73].…”

“…When it comes to fungal infections that involve the subcutaneous fat, they can be divided into two major types: (1) panniculitis in the setting of a disseminated fungal infection and (2) classical subcutaneous mycosis (with the most important being mycetoma, chromoblastomycosis, and sporotrichosis), introduced into the subcutaneous tissue from the environment via inoculation. Cytomegalovirus has been rarely reported as a causative agent; immunocompromised patients were particularly affected, as in most of these IP [72,73]. Similarly, there has been sporadic reports on parasitic organisms (Leishmania spp.…”

“…Bacterial IP should be strongly considered when extensive suppurative panniculitis with perivascular, lobular, or mixed septal-lobular neutrophil-dominated infiltrate is present, which often extends into the dermis (Fig. 9b) [58,72]. IP caused by atypical mycobacteria or deep fungal infection shows suppurative granulomas within the lobule, which consist of collections of neutrophils surrounded by epithelioid histiocytes [39,73].…”