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Cellulitis

Definition

Cellulitis is an infection of the skin and tissue just below the skin. The infection may occur anywhere on the body. It is most common on the lower legs.

Causes    TOP

Cellulitis is caused by a bacterial infection. It may come from bacteria that normally live on the skin or bacteria from other sources. The bacteria enter the skin through a cut or injury. The infection spreads into the surrounding skin.

Risk Factors    TOP

Factors that may increase the chance of cellulitis include:

  • A untreated minor injury to the skin such as, a cut, scratch, blister, burn, puncture, or bite
  • Injuries that occur in natural bodies of water
  • Bacteria that enter the body through surgical wounds or a catheter in a vein
  • Having certain conditions such as diabetes, HIV, weakened immune system, kidney or liver disease, obesity, or poor circulation
  • Abusing alcohol or drugs
  • Taking steroids on a regular basis
  • Undergoing surgery
  • Retaining fluids
  • A fungal infection of the foot
  • Handling certain foods, like raw fish, meat, shellfish, poultry, and eggs

Puncture Wound

Puncture Wound
Copyright © Nucleus Medical Media, Inc.

Symptoms    TOP

Symptoms may begin within hours or days and can include:

  • Skin inflammation that begins in a small area and spreads with:
    • Redness and warmth
    • Pain or tenderness
    • Swelling
    • Dimpled skin
    • Streaking—spreading of redness
  • Swollen lymph nodes
  • Fever or chills
  • Fatigue
  • Confusion

Cellulitis near the eyes may cause pain with eye movements and should be treated right away.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will also ask about exposure to natural bodies of water or animals. Your skin will be closely examined. The border of the cellulitis on your skin may be marked. This will help to monitor its progress

Tests may include:

  • Wound culture to test for the bacteria causing the infection
  • Blood tests to see if the infection has spread to the bloodstream

In severe cases, the infection can lead to tissue death known as gangrene. It can also spread to the bone or other structures.

Images are not usually needed. They may be taken of your bodily structures if there is concern about spreading. This can be done with:

Treatment    TOP

The goal is to eliminate the infection and reduce discomfort. Most cases resolve after 1-2 weeks of treatment.

Hospital care may be needed if you have:

  • Severe cellulitis
  • Diabetes or a weakened immune system
  • An infection on your face

Treatment includes:

Medication

Antibiotics may be given by mouth, injection, or IV. The method will depend on the severity of the infection. The antibiotic chosen will depend on the bacteria causing the infection. Pain medication may also be prescribed.

Supportive Care

This may include:

  • Elevating the infected area higher than your heart
  • Changing any dressings as directed by your doctor
  • Applying warm compresses
  • Protecting your skin from additional injury
  • Avoiding scratching or rubbing the area

Other Treatments    TOP

If you have an infected wound, it will need to be cleaned. Dead tissue may be removed. In certain situations, a collection of pus may develop. This is called an abscess. It can be drained.

Prevention    TOP

To help reduce your chance of cellulitis:

  • Keep your skin clean and dry.
  • Moisturize dry skin with lotion.
  • Avoid injury to the skin:
    • Wear protective gear in sports.
    • Wear long pants and long-sleeved shirts when hiking.
    • Wear sandals when at the beach, rather than going barefoot.
    • Be careful around animals. Treat pets with respect to avoid bites.
  • 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 care for the wound:
    • Clean cuts or scrapes with soap and water.
    • Apply antibiotic ointment.
    • Cover wounds with a bandage or dressing.
    • Do not scratch wounds.
    • Call the doctor right away if the area becomes red or inflamed.
  • Seek prompt medical care for larger wounds or bites.
  • Wash your hands after coming in contact with fish, poultry, eggs, or meat. Do not handle these items if you have cuts or sores.
  • If your legs tend to swell, elevate them several times a day and wear support stockings.

RESOURCES:

American Academy of Dermatology
https://www.aad.org
National Institute of Allergy and Infectious Diseases
https://www.niaid.nih.gov

CANADIAN RESOURCE;

Canadian Dermatology Association
https://dermatology.ca

References:

Cellulitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116794/Cellulitis. Updated August 14, 2017. Accessed August 17, 2017.
Cellulitis. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/rashes/cellulitis. Accessed August 17, 2017.
Cellulitis. DermNet New Zealand website. Available at: https://www.dermnetnz.org/topics/cellulitis. Updated July 2016. Accessed August 17, 2017.
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-159.
Last reviewed August 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 9/9/2014

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