Cellulitis
Definition
Cellulitis refers to an infection of the skin that may spread to tissue just beneath the skin's surface. It may occur anywhere on the body, but most commonly affects the face or lower legs.
Causes
Cellulitis is usually caused by a bacterial infection. Bacteria that normally live on the skin can cause cellulitis, or other bacteria may be the cause. The bacterial infection may be caused by:
• A minor injury to the skin, such as a cut, scratch, blister, puncture, or bite, that becomes infected and spreads into the surrounding skin.
• Chickenpox blisters that open up and become infected with bacteria
• Injuries that occur in natural bodies of water that become infected with germs found in the water
• Handling fish, poultry, eggs, or meat and getting a cut or abrasion that becomes infected by bacteria in the food product.
• Bacteria that enter the body through surgical wounds or a catheter in a vein
• Infection in a person with diabetes or a weakened immune system
• Bacteria spreading from an upper respiratory or ear infection
• Impaired circulation (tends to cause recurrence of cellulitis)
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
• Insect, animal, or human bites
• Diabetes
• Weakened immune system, such as AIDS
• Alcoholism
• Chronic use of steroids
• Kidney and liver failure
• Surgical procedures
• Poor circulation or peripheral vascular disease
• Swelling or fluid retention
• Intravenous drug abuse
• Burns
• Exposure to fish, meat, hides, shellfish, poultry, or eggs
Symptoms
Symptoms may begin within hours or days and can include:
• Skin inflammation that begins in a small area and spreads. This includes:
o Redness
o Pain or tenderness
o Swelling
o Warmth
o A red streak (possibly)
• Swollen lymph nodes
• Fever or chills
• Fatigue
• Headache
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Expect to answer questions about how the wound occurred and exposure to animals or natural bodies of water. Your skin will be closely examined. Using a colored pen on your skin, the doctor can mark the border of the cellulitis to monitor its progress.
Tests may include:
Wound Culture – a sterile applicator swabbed across the area and sent to a lab to be tested for bacteria and type of antibiotics to use in treating the infection. (This test is rarely, if ever, performed anymore since the bacteria on the swab will reflect the bacteria that colonize our skin normally and, hence, the test is not useful.)
Blood Tests – to help determine the severity of the infection
X-rays or Bone Scans – to check for gangrene under the skin or evidence that the infection has spread to the bone
Treatment
Treatment aims to eliminate the infection and reduce discomfort. Most cases of cellulitis resolve after a week or two of treatment. An infected wound can be cleaned and any dead tissue removed. If a collection of pus (called an abscess) is present, it can be drained. Severe cellulitis, cellulitis in a diabetic or immune suppressed person, or an infection on the face may require hospital care.
Treatment includes:
Medication
Antibiotics may be taken by mouth or injected into a muscle or vein, depending on the severity of the infection. Take the entire prescription as directed until all the medicine prescribed is used. Otherwise, the infection may return.
Supportive Care
This may include resting in bed or elevating the infected area higher than your heart. The doctor might recommend applying warm or cool compresses to the area. Change your dressings as directed by your doctor, and protect your skin from additional injury. Do not scratch or rub the area.
Prevention
To reduce your risk of getting cellulitis:
• Keep your skin clean.
• Moisturize dry skin with lotion.
• Avoid injury to the skin.
o Wear protective gear when participating in sports.
o Wear long pants and long-sleeved shirts when hiking.
o Wear sandals when at the beach, rather than going barefoot.
o Be careful around animals. Treat pets with respect to avoid bites.
• If you or your child has not had chickenpox, talk to your doctor about getting vaccinated.
• Do not swim in natural waters if you have cuts or sores.
• Try not to cut yourself during fishing or other water sports.
• If a small cut, bite, or other injury occurs, carefully tend to the wound.
o Clean cuts or scrapes with soap and water.
o Apply antibiotic ointment.
o Cover with a bandage or dressing.
o Do not scratch wounds.
o Call the doctor immediately if the area becomes red or inflamed.
• Seek prompt medical care for larger wounds or bites.
• If your legs tend to swell, elevate them several times a day and wear support stockings.
• Get recommended vaccines for children and adults.
