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I had a first-hand lesson in Cellulitis recently when a family member developed the condition. Cellulitis is a spreading bacterial infection of the skin and the tissues directly underneath. We had to return to the hospital a few days later as the left foot and leg had become very swollen. Cellulitis that is not caused by a wound or catheter most often occurs on the legs and feet. Less common bacteria varieties can cause infection after animal bites, puncture wounds through wet shoes, or wounds exposed to freshwater lakes, aquariums, or swimming pools. Erysipelas, a skin infection that causes raised, firm, bright red patches of skin — Usually, it is caused by Streptococcus bacteria. Necrotizing fasciitis, also known as "flesh-eating strep" — This is an infection of the tissues below the skin, rather than the skin itself. Many people who develop cellulitis have no other medical problems and no obvious injury or skin damage that allowed the infection to occur. Your doctor can usually diagnose cellulitis based on your recent medical history, your symptoms and a physical examination. In most cases, your doctor is not able to specifically tell you what bacteria type has caused your infection. How long cellulitis lasts depends on the extent of the cellulitis, the bacteria that caused the infection and your general health. Treat minor skin wounds promptly — Gently wipe away dirt, wash with antibiotic soap, apply antibiotic ointment and cover with a clean bandage.
Seek medical attention — Medical attention is needed for all deep puncture wounds and animal bites and for all deep wounds involving a joint, hand or foot. If you have mild cellulitis, you can usually treat it at home with antibiotics taken by mouth. If you have severe cellulitis, you may need to be treated in the hospital with antibiotics given intravenously (into a vein). Community-acquired MRSA infections may worsen despite antibiotic treatment, because the antibiotics that are most commonly selected to treat cellulitis do not reliably kill this bacteria. In most cases, symptoms of cellulitis begin to improve within 24 to 48 hours after starting treatment with appropriate antibiotics.
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Severe or rapidly progressive cellulitis may lead to septicaemia (blood poisoning), necrotising fasciitis (a more serious soft tissue infection), or endocarditis (heart valve infection).
Although many people attribute an episode of cellulitis to an unseen spider bite, they are falsely blamed.
Lymphangitis is a red line originating from the cellulitis and leading to tender swollen lymph glands draining the affected area (eg in the groin with a leg cellulitis). Occasionally further investigations are required to rule out other possible diagnoses such as deep vein thrombosis of the leg, radiation damage following radiotherapy, or inflammatory breast cancer (carcinoma erysipeloides). The patient should be assessed for signs of sepsis, recognised by fever, malaise, loss of appetite, nausea, lethargy, headache, aching muscles and joints.
Bacterial infection below the skin is called necrotising fasciitis and is potentially very serious. Blood tests show raised white cell count (mainly neutrophils) and raised C-reactive protein.

It is not infrequent that cellulitis is diagnosed and treated when an inflammatory skin disease is actually responsible for redness and swelling. Cellulitis is potentially serious and should be assessed by a medical practitioner promptly. Oral antibiotics used commonly are penicillin, flucloxacillin, dicloxacillin, cefuroxime or erythromycin. In situations where a broader antibiotic cover is required, for example a diabetic patient with a foot ulcer complicated by cellulitis, amoxicillin and clavulanic acid may be used.
If infection is serious, the patient should be admitted to hospital urgently and resuscitated with fluids, oxygen and intraveonous antibiotics. Some patients with very frequent cellulitis may benefit from chronic suppressive antibiotic treatment with low-dose penicillin or erythromycin. Cellulitis – Cellulitis caused by bacteria type into the skin usually by a cut, abrasions, or break in the skin. The photos shown here of cellulitis cases are more severe than what may appear to be normal in the early stages. This reddened skin or rash may signal a deeper infection, more serious than the inner layer of skin.
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The doctors at the hospital diagnosed him with it, along with Bursitis, which is an inflammation of the bursae, the fluid-filled sacs found around joints. It can be caused by many different bacteria - usually the Streptococci - which spread rapidly in the skin because they produce enzymes that don't allow the tissue to confine the infection. Bacteria break through the skin's protective outer layer, typically at the site of an injury, such as a cut, puncture, sore, burn or bite. Erysipelas occurs most often on an arm or leg that has been damaged by previous surgery or is chronically swollen due to poor lymph flow (lymphedema). Without proper antibiotic treatment, some forms of cellulitis can cause serious complications within a few days, even in otherwise healthy people. Your doctor will choose a specific antibiotic depending on the site of your cellulitis and the likely cause of your infection. However, keep in touch with your doctor to be sure that the infection is improving as expected.
If within the first two or three days of treatment you don't have obvious improvement in your skin pain, redness, and swelling, or if you develop blisters or pus on the surface of your skin rash, contact your doctor immediately.
Call your doctor promptly if you get a deep puncture wound, especially on a hand or foot, or if you are bitten by an animal or human. Always take all the antibiotics prescribed by your doctor, even if you think your infection has been cured.
This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Serious infection leads to hypotension (low blood pressure, collapse), reduced capillary circulation, heart failure, diarrhoea, gastrointestinal bleeding, renal failure and loss of consciousness.
It is recognised by severe pain, skin pallor, local anaesthesia, purpura, ulceration and necrosis. The management of cellulitis is becoming more complicated due to rising rates of methicillin-resistant Staphylococcus aureus (MRSA) and macrolide- or erythromycin-resistant Streptococcus pyogenes. The usual intravenous antibiotics used are penicillin-based antibiotics (eg penicillin G or flucloxacillin) or cephalosporins (eg ceftriaxone, cefotaxime or cefazolin) for a few days. However if there are signs of systemic illness or extensive cellulitis, treatment may require intravenous antibiotics either as an outpatient or in hospital.

The usual intravenous antibiotics used are penicillin-based antibiotics (eg penicillin G or flucloxacillin) or cephalosporins (eg cefotaxime, ceftriazone or cefazolin) for a few days. The doctor may also suggest blood tests, a wound culture or other tests to help rule out blood clots in the leg veins. Once under the skin, the bacteria can spread rapidly, entering the lymph nodes and the bloodstream and spread throughout the body. Prompt treatment with antibiotics can prevent the infection from spreading rapidly and reaching the blood and organs, leading to sepsis. He also started taking Turmeric and for skincare, he began applying an infection-fighting herb, Tea tree oil (Melaleuca spp., or ylang ylang) to the knee with a moist cotton ball. It often develops where there is edema (swelling), poor blood flow, or a skin rash that creates breaks in the skin, such as a fungus infection between the toes (athlete's foot). During the last several years, it has become more common for a strain of drug-resistant bacteria to cause cellulitis. Because infection around the eye can spread to the brain if it is not quickly treated with antibiotics, periorbital cellulitis requires prompt medical attention. Erysipelas also can develop on the face, typically across the bridge of the nose and upper cheeks.
The area of warmth can be felt with the back of the hand, especially when compared to surrounding skin. Bloodstream infections (blood poisoning) from cellulitis are particularly dangerous in the very young and very old, as well as in those with weakened immune systems or abnormal heart valves. At home, warm compresses, such as a warm, moist washcloth, and elevating the infected area can help. The prognosis is generally good, but the condition can return, especially in people with poor circulation, chronic (long-term) swelling in the legs or skin that is in poor condition.
Symptoms and signs are usually localised to the affected area but patients can become generally unwell with fevers, chills and shakes (sepsis or bacteraemia).
The most common infecting organisms are Streptococcus pyogenes (two thirds of cases) and Staphylococcus aureus (one third). Treatment for uncomplicated cellulitis is usually for 10 to 14 days but antibiotics should be continued until all signs of infection have cleared (redness, pain and swelling) – sometimes for several months.
Cellulitis in the lower leg is characterized by signs and symptoms that may be similar to clot occurring deep in the veins, such as warmth, pain and swelling (inflammation). Once beneath the skin surface, bacteria multiply and make chemicals that cause inflammation in the skin. This bacteria is named community-acquired methicillin-resistant staphylococcal aureus, or "community-acquired MRSA." Infections with this type of bacteria can lead to blistering of the skin or deep, more serious infections. There may be a spreading network of red streaks in the skin, caused by infection in the vessels that carry lymph (tissue fluid), as well as enlarged lymph nodes (swollen glands) near the area of infection. Knowledge of local organisms and resistance patterns is essential in selecting appropriate antimicrobial therapy.
He awoke in the middle of the night to find his left knee was swollen, red, painful and after about 12 hours he began complaining of headaches. Prior to our arrival at the hospital, I applied some arnica montana gel to the affected area. A line was drawn on the skin around the area of infection so it could be observed in case it started to spread.

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21.05.2014, author: admin

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