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Suggest Treatment For Facial Cellulitis, Persistent Headache, Vertigo And Depression
Question: In October I had facial cellulitis. I was admitted to hospital for 3 days and had IV antibiotics followed by a week of oral antibiotics. As well as blood tests i had a chest X-ray, ECG and CT scan of my head - all of which were apparently normal. Since then I have had an almost permanent headache. It's not a really bad headache - about 3 or 4 on a scale of 1-10 but it won't go away. I don't know if it is related to the cellulitis and it's really worrying me. If it's just a tension headache surely it should have gone by now. It moves around a bit - sometimes it's at the front of my head but most of the time most of the time it's at the back, spreading down my neck and left shoulder (the cellulitis was on the right side of my face/head).
Also, about 2 weeks ago I had an episode of vertigo which lasted about 2-3 hours. I don't know if that was connected with the headache and/or the cellulitis or completely random. I am a 60 year old woman and in all other ways perfectly healthy except that since Aug/Sept I have been taking citalopram for anxiety/depression (which is now a lot better). I would appreciate any advice you can give.
Also, about 2 weeks ago I had an episode of vertigo which lasted about 2-3 hours. I don't know if that was connected with the headache and/or the cellulitis or completely random. I am a 60 year old woman and in all other ways perfectly healthy except that since Aug/Sept I have been taking citalopram for anxiety/depression (which is now a lot better). I would appreciate any advice you can give.
Brief Answer:
Investigations / Physical Examination and correlation
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
To recapitulate: 60/ F - cellulitis on right face and head in Oct - admitted treated and investigated - ''permanent headache'' - moves around a bit - back of head > neck > left shoulder - has vertigo for 3 hours - Citalopram and paracetamol ...
Needs advise.
Your chronologically putting the history helps me to advise you the following::
-Get an MRI of the brain with MRI Venogram and MRI of the cervical spine with angiogram. I will try to explain :
MRI of the brain to rule out any meningitis.(Headache).
MRI Venogram to see if the veins of the brain have any thombosis or so (headache)
MRI of the cervical spine- to see any discs which can give the similar problem of pains you have described.
MRI Angiogram of the neck, particularly to see any associated changes in the
vertbral arterial blood supply ( one of the reasons of vertigo, although was temporary)
-Check up by an Ophthalmologist
-I hope a Neurologist's opinion is already sought.
If all the opinions and investigations are within normal, you may need an altered dose of citalopram or additional treatment as may be thought by your Physician
I have tried my best to suggest you something as p[er the history you have provided. You certainly need a proper clinical / physical examination by Doctors
to find out any evidence that might need an additional investigations and treatment.
Please feel free to ask for more if you need or if you feel there is a gap-of-communication.
Investigations / Physical Examination and correlation
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
To recapitulate: 60/ F - cellulitis on right face and head in Oct - admitted treated and investigated - ''permanent headache'' - moves around a bit - back of head > neck > left shoulder - has vertigo for 3 hours - Citalopram and paracetamol ...
Needs advise.
Your chronologically putting the history helps me to advise you the following::
-Get an MRI of the brain with MRI Venogram and MRI of the cervical spine with angiogram. I will try to explain :
MRI of the brain to rule out any meningitis.(Headache).
MRI Venogram to see if the veins of the brain have any thombosis or so (headache)
MRI of the cervical spine- to see any discs which can give the similar problem of pains you have described.
MRI Angiogram of the neck, particularly to see any associated changes in the
vertbral arterial blood supply ( one of the reasons of vertigo, although was temporary)
-Check up by an Ophthalmologist
-I hope a Neurologist's opinion is already sought.
If all the opinions and investigations are within normal, you may need an altered dose of citalopram or additional treatment as may be thought by your Physician
I have tried my best to suggest you something as p[er the history you have provided. You certainly need a proper clinical / physical examination by Doctors
to find out any evidence that might need an additional investigations and treatment.
Please feel free to ask for more if you need or if you feel there is a gap-of-communication.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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