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Cellulitis

 

Definition

     Cellulitis is an acute inflammation of the connective tissue of the skin, caused by infection with staphylococcus, streptococcus or other bacteria

Causes

     The typical causal agents are two: the gram-positive bacteria Staphylococcus aureus ("staph") and Streptococcus ("Strep"). Other bacteria may also cause Cellulitis, such as the gram-negative Escherichia coli.

Symptoms  

  • Localized skin redness or inflammation that increases in size as the infection spreads

  • Tight, glossy, "stretched" appearance of the skin

  • Pain or tenderness of the area

  • Skin lesion or rash (macule):

    • Sudden onset

    • Usually with sharp borders

    • Rapid growth within the first 24 hours

  • Warmth over the area of redness

  • Fever

  • Other signs of infection:

    • Chills, shaking

    • Warm skin, sweating

    • Fatigue

    • Muscle aches, pains (myalgias)

    • General ill feeling (malaise)

     Additional symptoms that may be associated with this disease:

  • Nausea and vomiting

  • Joint stiffness caused by swelling of the tissue over the joint

  • Hair loss at the site of infection

Screening and Diagnostics

  • Usually evident on examination

  • Culture by saline injection and aspiration (rarely done)

Treatment

  • Antibiotics:

    1. Cephalexin (Keflex) or Dicloxacillin by mouth in typical cases

    2. Cefazolin intravenously in severe cases

    3. Broad Spectrum antibiotics if gram-negative bacteria is suspected (especially diabetics)

Prognosis

     Cure is possible with 7 to 10 days of treatment. Cellulitis may be more severe in people with chronic diseases and people who are susceptible to infection (immunosuppressed).

Complications  

  • Tissue death (gangrene)

  • Sepsis, generalized infection and shock

  • Meningitis (if cellulitis is on the face)

  • Lymphangitis (inflammation of the lymph vessels)

Prevention 

     Avoid skin damage by wearing appropriate protective equipment when participating in work or sports. Also, clean any breaks in the skin carefully and watch for redness, pain, drainage, or other signs of infection.

     Finally, maintain good general health and control chronic medical conditions. A body that is healthy can more easily fight bacteria before they multiply and cause infection, while a body that is run down has less protection against infection.

 
 

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