Information About

Cellulitis





SYMPTOMS

Cellulitis is characterized by redness, swelling, warmth, and pain or tenderness. Cellulitis frequently occurs on exposed areas of the body such as the arms, legs, and face. Other symptoms can include fever or chills and headaches. In advanced cases of cellulitis, red streaks (sometimes described as ‘fingers’) may be seen traveling up the affected area. The swelling can spread rapidly.


CAUSES

Cellulitis is caused by a number of types of Bacteria entering by way of a break in the skin. This break need not be visible. Group A Streptococcus and Staphylococcus are the most common of these bacteria, which are part of the normal flora of the skin but cause no actual infection until the skin is broken. Predisposing conditions for cellulitis include insect bite, animal bite, pruritic skin rash, recent surgery, athlete’s foot, swollen skin, dry skin, eczema, and burns.


RISK FACTORS

The elderly and those with weakened immune systems are especially vulnerable to contracting cellulitis. Diabetics are more prone to cellulitis than the general population because of impairment of the Immune System ; they are especially prone to cellulitis in the feet because their disease causes impairment of blood circulation in their legs leading to their having foot ulcers that commonly become infected.

Immunosuppressive Drug s, HIV , and other illnesses or infections that weaken the immune system are also factors that make infection more likely. In addition, Chickenpox and Shingles often result in blisters which break, providing a gap in the skin which bacteria can enter through. Lymphedema , which causes swelling on the arms and/or legs, can also put an individual at risk.

Diseases that affect blood circulation in the legs and feet, such as Chronic Venous Insufficiency and Varicose Vein s, are also risk factors for cellulitis.


DIAGNOSIS

Cellulitis is most often a clinical diagnosis, and local cultures do not always identify the causative organism. Blood Culture s usually are positive only if the patient develops generalised Sepsis . Conditions that may resemble cellulitis include Deep Vein Thrombosis , which can be diagnosed with a compression leg Ultrasound , and Stasis Dermatitis , which is inflammation of the skin from poor blood flow.


INCUBATION

Cellulitis can develop in as little as twenty-four hours, or can take days to develop.


DURATION

In many cases, cellulitis takes less than a week to disappear with antibiotic therapy. However, it can take months to resolve completely in more serious cases, and can result in severe debility or even death if untreated.


TREATMENT

If the case of cellulitis is minor, oral Antibiotic s may be all that are necessary. These are often intended to be taken for about ten days, and the patient usually sees his or her doctor after a day or two of taking the medication to ensure that it is working correctly. In addition, the doctor may instruct the patient to elevate the affected area. Antipyretic s or Anti-inflammatory drugs may also be used.

If the oral antibiotics do not work or if the patient has a high fever when he or she comes to see the doctor, , and in specific situations Gram-negative organisms, anaerobic organisms, or specific species will be covered. If the infection forms an Abscess , it may require surgical incision and drainage of the collected pus.

In the most serious cases, the cellulitis may spread to the bloodstream (causing Septicemia ) and other tissue, especially bone (causing Osteomyelitis ). In these cases, or where antibiotic therapy is unsuccessful, surgical Debridement may be necessary.

In rare cases, secondary infections such as Necrotizing Fasciitis , where rapid necrotization of skin, fat, and connective tissue may necessitate surgical Debridement of affected areas.


PREVENTION

Good hygiene and good wound care lower the risk of cellulitis. Any wounds should be cleaned and dressed appropriately. Bandages should be changed daily or when they become wet or dirty will reduce the risk of contracting cellulitis. Medical advice should be sought for any wounds which are deep, dirty or if there is concern about retained foreign bodies.


FORMS OF CELLULITIS

A few of the forms of cellulitis are as follows: Periorbital Cellulitis (an infection of the eye socket), Erysipelas , Clostridial Cellulitis , Nonclostridial Cellulitis , and Synergistic Necrotizing Cellulitis (Pankey, 1992). A few forms of cellulitis do not have some of the symptoms most commonly listed (for example, clostridial and nonclostridial cellulitis do not cause the skin to turn red 1992 ), but the majority do. Necrotizing Fasciitis can be mistaken for cellulitis but is notable for involvement of the deeper tissue structures, the fascia, and can be limb and life threatening.


REFERENCES

  • MFMER. 'Cellulitis'. 3 July 2002. Mayo Foundation for Medical Education and Research. 30 Oct. 2003 {Link without Title} .

  • NLM. 'Group A streptococcal infections'. 2002. National Library of Medicine. 30 Oct. 2003 {Link without Title} .

  • Pankey, George A. "Approach to rashes and infections of the skin and subcutaneous tissues." Textbook of internal medicine. 2nd ed. 2 vols. Philadelphia: J. B. Lippincott Company, 1992.

  • Cellulitis Overview (with picture).

  • Cellulitis