Posted: June 8th, 2022
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UNITED STATES UNIVERSITY
Cellulitis is a common bacterial skin infection.
Affected skin may appear swollen, painful, and warm to the touch (Santos et al., 2018).
It mainly affects the lower legs, face and arms.
Hesitation to treat the disease can affect lymph nodes and the bloodstream, becoming life-threatening.
The bacteria enter through openings and skin cracks.
Affects the deep layers of the skin.
Streptococcus and staphylococcus infections are most common (Webb et al., 2020).
Signs & Symptoms
Pain in the affected area.
Skin dimpling (Sullivan & Barra 2018).
Bacteria invades open skin.
It overwhelms neutrophils, eosinophils, and basophils, causing inflammation over 1st 72 hrs.
(Sullivan & Barra 2018).
As infection progress it invades healthier cells.
Blisters formulate in the affected area.
Lymphatic filariasis- the disease is caused by microscopic parasites, and thread-like worms.
Chronic venous insufficiency- occurs when your lower legs veins fail to deliver back blood to the heart (Webb et al., 2020).
Acute deep venous thrombosis – blood clots in one or more deep veins.
Lipedema – excessive fat remains and accumulates in the victim.
– Skin examination
Gram stain and culture of fluid from abscess and bulla (Sullivan & Barra 2018).
Culture of the primary lesion by aspiration.
Blood cultures often negative
(only 10% positive)
Wound cultures often negative (70%)
Purulence = often S. Aureus.
Animal bites = often gram-negative bacteria.
Weakened immune system
History of cellulitis
Outpatient: Oral antibiotics.
Amoxicillin is commonly used due to its bioavailability
250-500 mg PO 3 x daily (Webb et al., 2020).
Usually 5 to 10 days, depending on severity.
Follow up in 3 days regarding progress
No improvement or new fever = ER visit.
Keep the infected area clean.
Record temperature daily for a week.
Maintain hygiene to avoid infection spread
(Webb et al., 2020).
Take entire abx supply until gone to avoid reinfection.
OTC drugs to use for pain
325-1000 mg PO q 8 hrs
200-600 mg PO q 8 hrs
Complications can be severe.
Can range from localized erythema to necrotizing fasciitis (”flesh-eating bacteria”).
Some strains can become resistant to antibiotics, requiring stronger agents (Vancomycin, Zosyn).
The infection might spread to the bones, blood, lymph system, nervous system, or heart (sepsis) (Santos et al., 2018).
May include extensive tissue damage, leading to amputation, shock, or even death.
Cellulitis is a disease that can be controlled effectively in the early stages.
Antibiotics effectively control the bacteria that cause the disease (Santos et al., 2018).
The infections attack the legs but can all skin and soft tissue areas.
Maintaining a high level of hygiene can help reduce the rate of infection.
Santos, J. C., Pinto, S., Ferreira, S., Maia, C., Alves, S., & da Silva, V. (2019). Pediatric preseptal and orbital cellulitis: a 10-year experience. International journal of pediatric otorhinolaryngology, 120, 82-88.
Sullivan, T., & de Barra, E. (2018). Diagnosis and management of cellulitis. Clinical Medicine, 18(2), 160.
Webb, E., Neeman, T., Bowden, F. J., Gaida, J., Mumford, V., & Bissett, B. (2020). Compression therapy to prevent recurrent cellulitis of the leg. New England Journal of Medicine, 383(7), 630-639.
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