Subcutaneous injection of small amounts of household insecticides or other hydrocarbon-based products may produce marked tissue damage. Chemical cellulitis may progress to form sterile abscesses, which are the result of a direct toxic effect of hydrocarbons and are not bacterial in origin, as consistently shown by microbial cultures. Formation of these sterile abscesses may be prolonged, as in the case presented here, but more often manifest within the first week after injection. Early recognition of abscess formation allows rapid intervention and shorter convalescence. All cases require incision, drainage or débridement. Although routinely used, we question the necessity of prophylactic antibiotic treatment, as evidenced by the sterility of all cultures and the fact that subsequent abscess formation was not prevented by their use. Close medical observation, preferably in an ICU, setting is necessary to exclude systemic toxicity which is related to the cholinesterase inhibitor component and may occur as late as 60 h after injection.
European Journal of Plastic Surgery – Springer Journals
Published: Feb 18, 2003
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