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Cellulitis (Signs, symptoms, treatment)
Cellulitis is a bacterial infection of the skin and underlying tissue. It is usually caused by streptococcal or staphylococcal bacteria. The skin of the face, neck, arms and legs is most often involved. Infection may also occur at sites of minor surgery or trauma.
Anyone of any age can be affected by cellulitis. However, infants, young children, the elderly, and people with weakened immune systems are most likely to be affected. Other factors than can increase the chances of developing the condition include:
- Problems with circulation in the limbs
- Previous injury to the limbs (eg: trauma, radiotherapy, surgery)
- Diabetes
- Alcoholism
- Obesity
- Swelling of the legs
- Pregnancy.
Signs and Symptoms
The onset of cellulitis is often sudden. A clearly defined area of skin becomes red and tender. It rapidly turns bright red, shiny, swollen and hot. During the initial stages of the rash there is often accompanying fever, chills, headache, nausea and a general feeling of ill health. The lymph nodes draining the affected area may become swollen and tender.
Orbital cellulitis affects the tissues around the eye. This form of cellulitis can be caused by bacteria that have spread from the nose, throat or sinuses. It can also occur after facial surgery.
Diagnosis
Cellulitis can usually be diagnosed from its characteristic appearance. Blood tests and tissue cultures may be used to confirm the presence of bacterial infection.
In cases of orbital cellulitis, a CT scan (computerised tomography) may be recommended in order to precisely identify the extent of the infection.
Treatment
It is important to seek medical treatment early for suspected cellulitis. The condition is treated with antibiotics, usually penicillin-based. In many cases improvement occurs within 48 hours of starting treatment. Treatment with antibiotics may need to be continued for up to 14 days or as prescribed by a doctor. In acute cases where the cellulitis is extensive, hospitalisation and treatment with intravenous antibiotics may be required. It is important to seek medical attention promptly if orbital cellulitis is suspected as the potential side affects of the condition include loss of vision and meningitis. Sometimes treatment from an eye specialist (ophthalmologist) may be required.
Recently there has been an increase in the number of cases of cellulitis showing resistance to the standard antibiotics. In these cases one or more different medications may need to be tried.
Cold packs and pain relieving medication may be used to reduce pain and discomfort.
In rare cases there may be several recurrences of cellulitis. This is particularly true of patients who have an underlying medical condition such as diabetes, postphlebitic syndrome or HIV infection. In selected patients where recurrence is a serious problem, ongoing preventative treatment with antibiotics may be recommended.
References
Leversha, Dr A (2005) Cellulitis. Starship Children’s Health Clinical Guideline. Starship Children’s Hospital. Auckland.
Stanway, Dr A. (2006) Cellulitis. New Zealand Dermatological Society Incorporated. http://www.dermnetnz.org/bacterial/cellulitis.html
Rowland, B. M. (2001) Cellulitis. Gale Encyclopaedia of Medicine. Gale Group Health and Wellness Resource Centre. Farmington Hills. MI.
Last Reviewed – 13/12/06
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