Cellulitis: Information, Causes, Treatment

Introduction

Cellulitis is a common infection of the skin and the soft tissues underneath the skin. It occurs when bacteria invade broken or normal skin and start to spread under the skin and into the soft tissues. If Cellulitis is not treated with antibiotics, the infection can spread to the blood or lymph nodes. This can be deadly.

Main Item

Skin on lower legs is most commonly affected, though cellulitis can occur anywhere on your body or face. Cellulitis may affect only your skin's surface or, cellulitis may also affect tissues underlying your skin and can spread to your lymph nodes and bloodstream. As this red area begins to enlarge, the person may develop a fever, sometimes with chills and sweats, and swollen lymph nodes ("swollen glands") near the area of infected skin.

What Causes Cellulitis

Cellulitis is caused by bacteria (usually strep or staph). Some people are at risk for infection by other types of bacteria. They include people with weak immune systems and those who handle fish, meat, poultry, or soil without using gloves. People with morbid obesity can also develop cellulitis in the abdominal skin. Special types of cellulitis are sometimes designated by the location of the infection. Examples include periorbital (around the eye socket) cellulitis, buccal (cheek) cellulitis, and perianal cellulitis.

Some people can get cellulitis without having a break in the skin. These include older adults and people who have diabetes or a weak immune system. These people are also more likely to develop dangerous problems from cellulitis. And they are more likely to get cellulitis again.

Other Risk Factors for Cellulitis Include:

• Wound from a recent surgery
• Cracks or peeling skin between the toes
• Injury or trauma with a break in the skin (skin wounds)
• History of peripheral vascular disease - peripheral vascular disease
• Insect bites and stings - Insect bites and stings, animal bites, or human bites
• Ulcers - Ulcers from diabetes or a blockage in the blood supply (ischemia)
• Use of corticosteroid medications or medications that suppress the immune system

Treatment of Cellulitis

The appearance of the skin will assist a doctor in determining a diagnosis. A doctor may also suggest blood tests, a wound culture or other tests to help rule out a blood clot deep in the veins of the legs. Cellulitis in the lower leg is characterized by signs and symptoms that may be similar to those of a clot occurring deep in the veins, such as warmth, pain and swelling (inflammation).

This reddened skin or rash may signal a deeper, more serious infection of the inner layers of skin. Once below the skin, the bacteria can spread rapidly, entering the lymph nodes and the bloodstream and spreading throughout the body. This can result in flu like symptoms with a high temperature and sweating or feeling very cold with shaking as the sufferer cannot get warm.

Treatment consists of resting the affected area, cutting away dead tissue, and antibiotics (either oral or intravenous). Flucloxacillin or Dicloxacillin monotherapy (to cover staphylococcal infection) is often sufficient in mild cellulitis, but in more moderate cases, or where streptococcal infection is suspected, then this course is usually combined with oral phenoxymethylpenicillin or intravenous benzylpenicillin, or ampicillin/amoxicillin (e.g. co-amoxiclav in the UK). Pain relief is also often prescribed, but excessive pain should always be investigated as it is a symptom of necrotizing fasciitis.

As in other maladies characterized by wounds or tissue destruction, hyperbaric oxygen treatment can be a valuable adjunctive therapy, but is not widely available.

The Henry Ford Health System recommends Cellulitis be treated with Vancomycin.

NOTE: Left untreated, Cellulitis may rapidly turn life-threatening. That's why it's important to seek immediate medical attention if cellulitis symptoms occur.