Cellulitis

What Is Cellulitis?

Cellulitis is a potentially serious bacterial infection of the skin, which includes the subcutaneous tissue, fat, and the soft tissue layer. The other name for cellulitis is Phlegmon. It first appears as an area that is hot to touch and is red and swollen. Cellulitis can occur anywhere in the body, but usually, it affects the skin of the lower legs and can be painful. It can spread to the deeper layers of the skin, lymph nodes, and blood rapidly and can be fatal.

What Are the Types of Cellulitis?

Cellulitis can occur anywhere in the body, so it is divided into different types depending on the body part affected.

1. Cellulitis of the Extremities - This affects the arms, legs, and feet. It is the most common type of cellulitis.

2. Facial Cellulitis - It can occur anywhere in the face, lips, and tongue.

3. Orbital and Periorbital Cellulitis - Skin infection of the eyelids or the structures surrounding the eye.

4. Breast Cellulitis - Women with breast cancer and a history of lumpectomy are more susceptible to develop breast cellulitis.

5. Perianal Cellulitis - This is usually seen in children. Here the skin around the anal orifice gets infected.

What Are the Causes and Risk Factors for Cellulitis?

Bacteria are present on the surface of the skin and normally do not cause any infection. But in the following cases, bacteria (Streptococcus and Staphylococcus) enters the skin and causes infection:

• Cut or trauma to the skin.

• Diabetes.

• Conditions causing poor blood flow to the arms and legs, for example, varicose veins.

• Liver diseases like hepatitis, cirrhosis, etc.

• Skin conditions like psoriasis, eczema, athlete’s foot, etc.

• Weak immune system.

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• Insect bite.

• Frostbite: Frostbite is caused due to the exposure of body parts to very low freezing temperatures. The extreme cold causes freezing of the skin and underlying tissues. The fingers, feet along with the toes are commonly affected. This might include the nose, ears, and cheeks.

• Infection after surgery.

• History of cellulitis.

• Intravenous drug users.

• Infectious diseases like chickenpox.

• Being overweight.

What Are the Signs and Symptoms of Cellulitis?

The usual signs and symptoms include:

• The affected area becomes red, swollen, tender, and painful.

• The skin will be warm to touch.

• Enlarged lymph nodes.

• There might be abscess formation with pus in the center.

• The skin appears glossy, tight, and swollen.

• Skin dimpling. Skin dimpling means having a skin texture similar to orange peel. This is due to the protrusion of the underlying fat through the weakened areas of connective tissue.

What Is Dental Cellulitis?

• Dental cellulitis will have a dental cause as the origin. When a dental abscess is unable to drain through the surface of the skin, cellulitis occurs.

• Streptococci are known to be the cause.

• There will be widespread swelling even in the eyes, extending even beyond the ears. There will not be any definite localization.

• The swelling will be red and painful. There will be tenderness on palpation.

• Tissues will be discolored. Temperature is elevated with malaise and lethargy.

• In severe cases, the pus may evacuate into the nose, vestibules, the floor of the mouth, infratemporal fossa and maxillary sinus.

• If the pus is seen on the superficial surface, erythematous spots are known to develop.

• Diagnosis involves a lot of laboratory tests. A biopsy might also be needed.

• Management of cellulitis involves a surgical incision and drainage. This may be accompanied by antibiotic therapy.

• Extraction of the affected tooth may be required.

When Do You Need to See a Doctor?

Untreated cellulitis might be fatal, so if you see the following symptoms, get immediate medical attention:

• Fever.

• Chills.

• Feeling tired.

• Dizziness.

• Muscle pain.

• Sweating.

• Drowsiness.

• Lethargy.

• Blisters and red streaks on the affected skin.

What Are the Methods to Diagnose Cellulitis?

The doctor will usually diagnose the condition through clinical presentation and physical examination. Sometimes, the doctor might ask for the following tests:

• Blood test - If the doctor suspects the infection to have spread to the blood.
• X-ray - To check if the underlying bone is infected.
• Culture - The fluid collected from the infected area is sent to the lab for a culture test.

What Are the Treatment Options for Cellulitis?

Oral Antibiotics:

Your doctor might prescribe oral antibiotics for 10 to 21 days. The length of the antibiotic regimen will depend on the severity of the infection. You will usually see improvement after taking oral antibiotics for 7 to 10 days, but complete the antibiotic course even after all the signs and symptoms go away.

Painkiller:

Along with antibiotics, your doctor might also prescribe painkillers to relieve the pain and discomfort caused by the infection.

IV Antibiotics:

If you have a high fever or high blood pressure or immunologically compromised or if oral antibiotics are not effective, then the doctor might advise hospitalization. In such cases, antibiotics are given intravenously.

Surgery:

In some rare cases, when the infection is severe, surgery might be needed. Here, the doctor may drain the collected pus and cut away dead tissue to promote healing.

Home Remedies:

• Elevate the infected part of the body.

• Take over-the-counter pain medications like Paracetamol or Ibuprofen.

• A cool and damp cloth can be placed on the affected area for comfort.

• Keep moving the joint near the affected area to prevent it from getting stiff.

• Drink plenty of fluids.

• Do not wear compression stockings until the infection is resolved.

How Can Cellulitis Be Prevented?

Following are some of the preventive measures:

• Keep your skin clean.

• Practice good personal hygiene.

• Do not wear tight-fitting socks and shoes.

• If you get injured, wash the area properly with warm water and soap.

What Are the Complications?

The complications include:

• Repeated and recurrent episodes of cellulitis can damage the lymphatic system and cause swelling of the limb.

• It can cause a deep-layer infection called necrotizing fasciitis.

• Blood infection.

• Bone infection.

• Gangrene (tissue death). It might occur due to poor blood flow or severe bacterial infection. It occurs in the hands and feet.

If you are suffering from cellulitis, which is not getting better with antibiotics, you can consult a dermatologist online. You can click pictures of the affected area and share it with the doctor along with the symptoms, or you can talk to an experienced doctor through real-time video consultation.