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Cellulitis

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Cellulitis

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Cellulitis is a bacterial infection affecting the skin. Read this article to learn the causes, symptoms, and risk factors.

Medically reviewed by

Dr. Yeshwanth Kumar

Published At March 12, 2019
Reviewed AtJanuary 4, 2024

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 the 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. This condition can be seen as red rashes on the lower legs above the ankles. It can spread to the deeper layers of the skin, lymph nodes, and blood rapidly and can be fatal.

Cellulitis

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.

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

  • Facial Cellulitis: It can occur anywhere on the face, lips, and tongue.

  • Orbital and Periorbital Cellulitis: Skin infection of the eyelids or the structures surrounding the eye.

  • Breast Cellulitis: Women with breast cancer and a history of lumpectomy are more susceptible to developing breast cellulitis.

  • 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?

Some people are at increased risk. However, bacteria are usually present on the skin's surface and normally do not cause infection. But in the following cases, bacteria (Streptococcus and Staphylococcus) enter the skin and cause 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.

  • Insect bites or bug bites can cause cellulitis, where the bacteria can enter through open skin when an itchy bug bites.

  • 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, and 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 the touch.

  • Enlarged lymph nodes.

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

  • The skin appears glossy, tight, and swollen.

  • Skin dimpling which 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 cannot 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 beyond the ears. There will be no 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 Does a Person Need to See a Doctor?

Untreated cellulitis might be fatal, so if the person sees 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.

cellulitis

What Are the Treatment Options for Cellulitis?

  • Oral Antibiotics: The doctor might prescribe oral antibiotics for skin infections for ten to 21 days. The length of the antibiotic regimen will depend on the severity of the infection. Usually, the person will see improvement after taking oral antibiotics for seven to ten days. Still, they will complete the antibiotic course even after all the signs and symptoms disappear.

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

  • Intravenous Antibiotics: If the person has a high fever or high blood pressure or is immunologically compromised or oral antibiotics are not effective, the doctor might advise hospitalization. In such cases, antibiotics are given intravenously.

  • Surgery: In some rare cases, surgery might be needed when the infection is severe. 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, 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 Does Home Remedies Aid in Cellulitis Recovery?

  • Warm Compress: Warm compress should be applied over the affected area to prevent swelling and other symptoms.

  • Elevation: Elevating the affected area will reduce the blood pressure in the region and help to enhance the blood flow.

  • Compression: Compression stockings or wraps can help to reduce the swelling and enhance the blood flow. The affected area should not be wrapped too tightly.

  • NSAIDs (Non-steroidal Anti-inflammatory Drugs): NSAIDs are used to lower the inflammation and pain caused.

How Can Cellulitis Be Prevented?

Following are some of the preventive measures:

  • Keep the skin clean.

  • Practice good personal hygiene.

  • Do not wear tight-fitting socks and shoes.

  • If the person gets 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 limb swelling.

  • 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.

Conclusion

Cellulitis is a dermatological condition caused due to bacterial skin infection which results in redness, swelling, and pain in the affected area. If cellulitis is not treated, then it can cause other serious health issues. Cellulitis can be prevented through proper hygiene and good wound care.

Frequently Asked Questions

1.

What Is the Main Reason for Cellulitis?

Cellulitis occurs due to bacterial infection. These bacteria can enter through a crack or break in your skin. Currently, the infection caused by Methicillin-resistant Staphylococcus aureus (MRSA) is highly increasing, and is the major cause of cellulitis.

2.

Which Treatment Is Effective for Cellulitis?

In mild cases, cellulitis can be treated with medications such as Dicloxacillin, Cephalexin, and Amoxicillin. In severe cases, incision and drainage may be required.

3.

Is Cellulitis Infection Dangerous?

Cellulitis is a severe infection affecting the deeper layers of skin and most of the underlying tissue. The infection might develop rapidly and can spread through the body. If not treated, the infection can lead to life-threatening complications.

4.

Can Cellulitis Be Transmitted?

Cellulitis cannot be transmitted from an infected person to another. Since it is caused by bacteria, the pus that is drained should be eliminated carefully in a hospital set up. There is an increased risk of developing cellulitis through a cut, injury, fracture or burns.

5.

When Is a Person Prone to Cellulitis?

Certain conditions raise the risk of developing cellulitis and other skin infections. Those conditions include having a weakened immune system, having a history of cellulitis or other skin problems, obesity, lymphedema, and use of injectable drugs.

6.

What Happens If Cellulitis Gets Severe?

People with a mild form of cellulitis might heal with antibiotics. If the symptoms of cellulitis begin to get worse, the infectious substances get released. When the release continues, the body continues to react in many abnormal ways.

7.

Will My Cellulitis Go Away?

Cellulitis should usually subside within seven to ten days after you start antibiotic therapy. A longer treatment might be needed in severe cases. The curative rate may be delayed due to chronic conditions or a poor immune system. You have to continue antibiotics for some days till your doctor advises you to stop.

8.

How Long Does It Take for Cellulitis to Develop?

The time it takes for the symptoms of cellulitis to develop varies depending on the bacteria responsible for the infection. When cellulitis is caused by Pasteurella multocida species, which is commonly found in animal bites, the symptoms can occur in less than 24 hours after the bite.

9.

Is Cellulitis an Autoimmune Disorder?

An autoimmune disorder is the one that displays a weakened immune response. An autoimmune disorder like rheumatoid arthritis can make a person more susceptible to cellulitis. This does not mean cellulitis itself is an autoimmune disorder.

10.

How Long Should I Stay in Hospital After the Treatment of Cellulitis?

The duration of stay in the hospital after the treatment for cellulitis usually lasts for three to five days. In case of severe infection, you might have to stay longer. You may need a proper dressing and wound care before discharge.
Dr. Yeshwanth Kumar
Dr. Yeshwanth Kumar

Dermatology

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