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Cellulitis
Cellulitis is an acute infection of the deeper layers of skin and subcutaneous tissue, caused by bacteria like Staphylococcus and Streptococcus. It presents with redness, warmth, pain and swelling at the affected site and can spread rapidly if not treated promptly with antibiotics. Risk factors include skin injuries, underlying skin conditions, and immunocompromised states. Treatment involves antibiotics targeting the suspected bacteria, along with elevating the limb, applying warm compresses and carefully monitoring the infection site.
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Introduction to cellulitis presented by Dr. Vijay Diora.
An acute skin infection affecting deeper layers; includes periorbital cellulitis in children.
Focus on serious infections involving deeper skin structures.
Causes include Staphylococcus, Streptococcus, and H. influenzae, particularly in children.
Local trauma, skin infections, or underlying conditions increase cellulitis risk.
Includes redness, warmth, pain, and mild systemic symptoms like fever and chills.
Physical signs include erythema, edema, warmth, and possible purulent discharge.
Increased body temperature, pulse, and lymph node swelling as systemic indications.
Wound discharge culture for identifying pathogens and antibiotic sensitivity.
Rapid treatment is critical due to potential progression to necrotizing fasciitis.
Key objectives include infection resolution, abscess formation identification, and tetanus check.
Warm/cool compresses, monitoring erythema spread, rest, and limb elevation recommended.
Pain management and antibiotic regimens based on infection type and allergy history.
Safe medication options for pregnant/breastfeeding women with cellulitis.
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Cellulitis
- 1. CELLULITIS Dr. vijaydihora
- 2. DEFINITION Anacute, diffuse, spreading infection of the skin, involving the deeper layers of the skin and the subcutaneous tissue. Periorbital cellulitis is a special form of cellulitis that usually occurs in children. In this form of cellulitis, unilateral swelling and redness of the eyelid and orbital area, as well as fever and malaise are usually present.
- 3. Serious infections ofdeeper skin structures
- 4. CAUSES Staphylococcus Streptococcus Group A β H. Influenzae (periorbital cellulitis) pasteurella multocida Facial cellulitis in children < 3 years old Hemophilus influenzae or Streptococcus pneumoniae
- 6. PREDISPOSING RISK FACTORS Local trauma (e.g., lacerations, insect bites, wounds, shaving) Skin infections such as impetigo, scabies, furuncle, tinea pedis Underlying skin ulcer Fragile skin Immunocompromised host Diabetes mellitus Inflammation (e.g., eczema) Edema secondary to venous insufficiency or lymphedema
- 7. TYPICAL FINDINGS OF CELLULITIS History Presence of predisposing risk factor Area increasingly red, warm to touch, painful Area around skin lesion also tender but pain localized Edema Mild systemic symptoms – low-grade fever, chills, malaise, and headache may be present
- 8. Physical Assessment Local symptoms: Erythema and edema of area Warm to touch, Possibly fluctuant (tense, firm to palpation) May resemble peau d’orange Advancing edge of lesion diffuse, not sharply demarcated Small amount of purulent discharge may be present Unilateral
- 9. Systemic indications: Increased temperature Increased pulse Lymphadenopathy of regional lymph nodes and / or lymphangitis
- 11. Diagnostic Tests Swab any wound discharge for culture and sensitivity
- 12. MANAGEMENT AND INTERVENTIONS Do not underestimate cellulitis. It can spread very quickly and may progress rapidly to necrotizing fasciitis. It should be treated aggressively and monitored on an ongoing basis
- 13. Goals of Treatmentfor Mild Cellulitis Resolve infection Identify formation of abscess Check tetanus prophylaxis
- 14. Non-pharmacologic Interventions Apply warm or, if more comfortable, cool saline compresses to affected areas qid for 15 minutes. Mark border of erythema with pen to monitor spread. Elevate, rest and gently splint the affected limb.
- 15. Pharmacologic Interventions Painmanagement: acetaminophen 10-15mg/kg per day po q4-6hours. Do not exceed 75mg/kg per 24 hours Oral antibiotics if no known MRSA or non-purulent cellulitis: cephalexin 40mg/kg per day po divided qid for 7-10 days uUsually first choice due to taste), or cloxacillin 40mg/kg per day po divided qid for 7-10 days Patients with penicillin allergy: erythromycin 40 mg/kg/day divided bid for 7-10 days Patients with known community acquired MRSA or purulent cellulitis: trimethoprim-sulfamethoxazole 8-12 mg / kg per day po bid for 7 days (dosing is based on trimethoprim)
- 16. Pregnant or BreastfeedingWomen Cephalexin, cloxacillin, erythromycin and acetaminophen may be used as listed above. Trimethoprim-sulfamethoxazole is contraindicated