Disease: Cellulitis

What Is Cellulitis?

A bacterial infection that often shows up as a rash, cellulitis can spread rapidly.

Cellulitis is an infection of the skin and deep tissue that’s most commonly caused by staphylococcus and streptococcus bacteria.

Cellulitis appears as a red, swollen skin rash (usually on the lower legs or arms) that feels tender and hot. It can spread rapidly over the course of 24 hours.

Cellulitis Symptoms

The symptoms of cellulitis include:

  • Skin rash that begins suddenly and spreads quickly over the course of a day
  • Areas of inflamed red skin that grow larger
  • Tenderness in the affected area
  • Pain
  • Skin that appears tight or stretched
  • Fever

If the area is infected, you may also experience:

  • Chills
  • Fatigue
  • General malaise
  • Muscle aches and pains
  • Sweating

Risk Factors for Cellulitis

Bacteria, including staphylococcus and streptococcus, can cause cellulitis to enter your body through cracks or tears in the skin. You may be at greater risk for cellulitis if:

  • You have a cut, scratch, or bug bite.
  • You have athlete’s foot or eczema.
  • You are using corticosteroid medications or medications that suppress your immune system.
  • You are overweight. Being overweight also increases your risk of recurrent cellulitis.
  • You have a weakened immune system from diabetes, kidney or liver disease, leukemia, or HIV/AIDS.
  • You have had cellulitis before.

Diagnosing Cellulitis

Your doctor will check the area of the rash to see if your symptoms are consistent with cellulitis. He or she may mark the area of the rash with a marker to track its spread.

Blood tests may also be ordered to rule out the possibility of a blood clot, as a clot and cellulitis can have similar symptoms.

Cellulitis Treatment

Cellulitis is normally treated with a 10- to 14-day course of prescription oral antibiotics to treat both staphylococcus and streptococcus bacteria.

You’ll also need to keep the affected area elevated higher than your heart to help reduce swelling.

The symptoms of cellulitis generally improve greatly or disappear after a few days of treatment; however, it’s important to continue taking your antibiotics for the full course so that the bacteria are completely killed.

If your symptoms don’t improve, worsen, or if you are running a high fever, call your doctor, because you need to receive antibiotics intravenously.

Complications of Cellulitis

Prompt treatment of cellulitis is important to prevent more serious complications. If the bacteria infect deeper layers of skin, it may enter your bloodstream or lymph nodes, making it more challenging to treat.

Repeat cases of cellulitis may damage your lymphatic drainage system and lead to chronic swelling of the affected limb.

In rare cases, cellulitis may spread to deeper layers of soft tissue and result in necrotizing fasciitis.

If you contract necrotizing fasciitis, you will need to receive antibiotics intravenously and in advanced cases may need to have dead tissue surgically removed.

Preventing Cellulitis

To prevent cellulitis, it’s important to take proper care of your scrapes and cuts. Always wash your wound with soap and warm water, apply an antibiotic ointment, and cover with a bandage to prevent bacteria from entering the bloodstream.

If you have diabetes or another condition that causes you to have poor circulation, it’s important to apply a moisturizing lotion daily to keep skin lubricated and healthy.

You should also inspect your feet regularly for any cracks or tears; treat athlete’s foot promptly; and regularly trim your nails to prevent scratches.

Sources:

  • Cellulitis (MedlinePlus)
  • Diseases and Conditions: Cellulitis (MayoClinic)

What Causes Cellulitis?

A tiny cut or bug bite can become infected, leading to serious complications.

Cellulitis is a bacterial skin infection caused by staphylococcus or streptococcus bacteria. The infection is not contagious.

Bacteria live on everyone’s skin, so when there is a tear, cut, or abrasion, bacteria can enter the deeper layers of the skin and cause an infection.

The abrasion could be so minor you don’t even see it, for example, a bug bite, a small nick from shaving, or from a chronic skin condition such as eczema.

Cellulitis may also occur in those with diabetes or who are taking medication that suppresses the immune system.

Risk Factors of Cellulitis

You are at greater risk for cellulitis if you:

  • Have an open cut or wound
  • Have a chronic skin condition, such as eczema, that causes irritation and minor cracks in the skin
  • Have a fungal or viral skin infection, such as athlete's foot or chickenpox
  • Are overweight
  • Use corticosteroid medications or other medications that suppress the immune system
  • Experience edema, accumulation of fluid due to poor circulation, liver or heart disease, or past surgery to remove lymph nodes
  • Are undergoing radiation therapy
  • Have a history of peripheral vascular disease
  • Have ulcers from certain diseases, including diabetes and vascular disease
  • Have a weakened immune system from diabetes, kidney or liver disease, leukemia, chemotherapy or HIV/AIDS
  • Have had cellulitis before

What Is Staph bacteria?

Staphylococcus aureus, more commonly known as staph, is a bacterium that lives on the skin or in the nasal lining of up to 30 percent of the population.

Staph can lead to cellulitis, other skin infections, and more serious illnesses that involve the lungs, kidneys, brain and even heart valves.

In healthy individuals, staph generally does not cause any problems, unless you have a skin injury, sometimes even a minor one.

People with a weakened immune system are at a greater risk for staph-related infections.

What Causes Perianal Streptococcal Cellulitis?

Perianal streptococcal cellulitis is caused by streptococcusbacteria and results in an inflammation of the anus and rectum.

It’s most common in children; the skin around the anus gets infected when a child scratches the area with his or her hands that have bacteria from their mouth or nose, or while cleaning after going to the bathroom. It often occurs with strep throat, nasopharyngitis, or impetigo.

What Is Orbital Cellulitis?

Orbital cellulitis is often caused by bacteria that enter the eye through direct trauma or a sinus infection. It’s most common in children.

Symptoms of orbital cellulitis may include pain, swelling, discoloration of the eyelids, poor vision, difficulty moving the eye, and fever.

What Causes Necrotizing Fasciitis?

Although rare in otherwise healthy individuals, cellulitis can spread to deeper layers of soft tissue, called the fascial lining. This is called necrotizing fasciitis.

It’s most often caused by A Streptococcus (group A strep), though other bacteria, including staph, can cause the infection.

Symptoms of necrotizing fasciitis include severe pain, swelling, redness of the infected area, black spots, blisters, or ulcers. High fever and signs of systemic inflammation are often present.

Necrotizing fasciitis — erroneously referred to as “flesh-eating bacteria” — can be a rapidly progressing and sometimes fatal infection. It requires prompt medical attention, generally including the use of antibiotics and surgery to remove dead tissue.

Sources:

  • A to Z: Cellulitis (KidsHealth)
  • Necrotizing Fasciitis: A Rare Disease, Especially for the Healthy (Centers for Disease Control and Prevention)
  • Patient information: Skin and soft tissue infection, by Larry M. Baddour, MD, FIDSA (Up to Date)
  • Perianal streptococcal cellulitis (MedlinePlus)

How to Treat Cellulitis

Treatment of cellulitis can vary, especially if you have a chronic illness or an impaired immune system.

Cellulitis is an infection of the skin and deep tissue caused by staphylococcus and streptococcus bacteria.

It appears as a red, swollen patch of skin (usually on your arm or lower legs) that feels hot, tender, and sometimes painful.

In most cases, oral antibiotics effectively treat the infection within 10 to 14 days.

Diagnosing Cellulitis

Your doctor will examine the affected area to determine if your symptoms are consistent with cellulitis. He or she may also examine your lymph nodes to check for signs of infection and test any fluid that has accumulated at the site of the rash.

Other tests may include blood tests to rule out blood clots, which may have similar symptoms, and a complete blood count (CBC) to check for an elevated white blood cell count, which indicates infection.

Your doctor may also circle the affected area with a pen to determine the extent of infection and see if it spreads over the course of a day or more.

Treatment for Cellulitis

Cellulitis is treated with a 10- to 14-day course of oral antibiotics that are effective against both staphylococcus and streptococcus bacteria.

Your symptoms should begin to clear after about three days; however, it’s important to take the full course of antibiotics because the bacteria may still be living even after you’re feeling better.

If your pain is intense, your doctor may also prescribe a pain medication or recommend an over-the-counter pain reliever. Elevating the affected area above your heart will also help reduce pain and swelling.

Treatment for Advanced Cases of Cellulitis

In rare cases, your cellulitis may not respond to treatment with oral antibiotics and you may need to be admitted to a hospital to receive intravenous antibiotics.

This scenario is most likely to occur if you have a chronic illness or an impaired immune system.

Treatment for Necrotizing Fasciitis

When cellulitis spreads to deeper layers of soft tissue, called the fascial lining, you may develop necrotizing fasciitis (sometimes erroneously referred to as “flesh-eating bacteria”).

Symptoms of necrotizing fasciitis include severe pain, swelling, and redness of the infected area as well as black spots, blisters, or ulcers. The condition is often accompanied by a fever, high white blood cell count and signs of systemic inflammation (such as high heart rate and respiratory rate).

Most common among people with compromised immune systems, the condition is rare in otherwise healthy individuals.

If you are diagnosed with necrotizing fasciitis, it’s important to begin treatment immediately; you will need to be admitted to the hospital to receive antibiotics intravenously.

If any tissue has begun to decay, it will need to be removed surgically as antibiotics have poor penetration of tissue with impaired blood flow that is starting to die (i.e., necrose).

Preventing Cellulitis

To prevent cellulitis:

  • Moisturize your skin to prevent cracks or tears.
  • Wear the appropriate protective equipment when playing sports or working.
  • Wear gloves in the winter and when washing dishes or cleaning to protect your hands.
  • Avoid sharing personal care items such as towels or razors.

Whenever you have a cut or bug bite:

  • Wash the area daily with warm soap and water. Apply a thin layer of antibiotic cream or ointment and cover with a bandage until the area heals.
  • Inspect the cut for redness, pain, drainage, or other signs of infection until it is healed.

Sources:

  • Cellulitis (MedlinePlus)
  • Diseases and Conditions Cellulitis (MayoClinic)
  • Necrotizing Fasciitis: A Rare Disease, Especially for the Healthy (Centers for Disease Control and Prevention)

Source: http://www.everydayhealth.com

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