title: Refractory facial cellulitis following cosmetic rhinoplasty after cord-blood stem cell transplantation.
abstract: We report a case of a 38-year-old female patient who developed facial cellulitis after cord-blood stem cell transplantation (CBT). The cellulitis was refractory to treatment with antibiotics and antifungal agents. Because facial cellulitis is rare after transplantation, its mechanism could not be determined exactly. On day 40 after CBT, a nurse with expertise in cosmetic surgery attended our rounds and correctly assumed that the patient had received cosmetic rhinoplasty. Although conventional x-rays of the head were normal, a computed tomographic (CT) scan of the brain disclosed the presence of a foreign body over the nasal dorsum. As a result, the patient's symptoms were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. At a pretransplantation interview, the patient did not mention her history of rhinoplasty. Even after she was shown the head CT scans that revealed the presence of nasal implants, she denied that she had received rhinoplasty before CBT. Unless we realize that patients may have received cosmetic surgery before transplantation, it is difficult to make a diagnosis of infection associated with foreign implants. To our knowledge this is the first report after transplantation of infection associated with cosmetic surgery. Such infections should be included on the list of complications after bone marrow transplantation.
authors.affiliation: Department of Hematology and Oncology, University of Tokyo, Japan. utako-tky@umin.ac.jp
authors.forename: U
authors.initials: U
authors.lastname: Machida
authors.forename: A
authors.initials: A
authors.lastname: Tojo
authors.forename: J
authors.initials: J
authors.lastname: Ooi
authors.forename: T
authors.initials: T
authors.lastname: Iseki
authors.forename: H
authors.initials: H
authors.lastname: Nagayama
authors.forename: N
authors.initials: N
authors.lastname: Shirafuji
authors.forename: M
authors.initials: M
authors.lastname: Sawada
authors.forename: K
authors.initials: K
authors.lastname: Nakayama
authors.forename: K
authors.initials: K
authors.lastname: Tani
authors.forename: S
authors.initials: S
authors.lastname: Asano
mesh_terms: D000328:Adult; D002481:Cellulitis / Q000209:etiology* / Q000473:pathology; D005148:Facial Dermatoses / Q000209:etiology* / Q000473:pathology; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005549:Foreign-Body Reaction / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D009666:Nose / Q000382:microbiology / Q000473:pathology; D012225:Rhinoplasty / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000139:chemically induced; D019172:Transplantation Conditioning / Q000009:adverse effects