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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 but it is most common on the lower legs. If it is not treated it can spread to other areas of the body.

Causes    TOP

Cellulitis is caused by a bacteria. The bacteria may normally live on top of the skin or come from other sources. It enters the skin through a cut or injury on the skin surface. Once inside the skin the bacteria can grow and cause infection.

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
  • Ulcer
  • Skin conditions that cause cracking or damage to the skin surface such as:
  • IV drug use
  • Surgery
  • Venous insufficiency
  • Lymphatic problems such as lymphedema
  • Having certain conditions such as diabetes, HIV, weakened immune system, kidney or liver disease, obesity, or poor circulation

Puncture Wound

Puncture Wound
Copyright © Nucleus Medical Media, Inc.

Symptoms    TOP

Symptoms may include:

  • Fever and chills
  • Skin may have:
    • Redness and feel hot to touch
    • Pain or tenderness
    • Swelling
    • Dimpled skin
    • Streaking—spreading of redness

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will also ask about any recent injuries. The area will be closely examined. The doctor may know it is cellulitis from the appearance of the skin. The outer edge of the redness may be marked. This will help to see if the infection spreads.

Your doctor may do blood tests. Fluid from the area may also be tested to find out what bacteria is causing the problem.

Treatment    TOP

The goal is to get rid of the infection and manage pain. Treatment may last 7-10 days. Most cellulitis will clear up 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 will help to clear the infection. Less severe infections may be treated with pills. The medicine may need to be injected or given by IV if the infection is severe. It is important to take all the medicine as given, even if the area looks better.

Pain medication may also be given to help manage pain.

Supportive Care

Keeping the area raised can help move fluids out. It may also speed healing.

It is important to protect the skin and stop further damage while you heal. This includes not scratching or rubbing the area. Use and change bandages as recommended by your doctor. Keep the area clean.

Prevention    TOP

To decrease the risk of breaks in the skin:

  • Keep your skin clean and dry.
  • Moisturize dry skin with lotion.
  • Follow your treatment plan for any skin conditions
  • Wear protective gear in sports.
  • Be careful around animals. Treat pets with respect to avoid bites.

To help reduce your chance of infections:

  • Regularly wash hands and bathe
  • If a small cut, bite, or other injury occurs:
    • 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 if the area becomes red or inflamed.
  • 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 March 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 3/13/2018

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