Cellulitis is a bacterial skin infection, which is quite common, and if not treated immediately, can prove to be fatal. Cellulitis is characterized by red and swollen skin, which is tender and hot to touch. Cellulitis can spread quite rapidly. Cellulitis commonly affects the skin on the lower legs; however, cellulitis can affect any part of the body. Cellulitis can be limited only to the skin's surface or it can affect the underlying tissues and further spread to the bloodstream and lymph nodes.
It's important to diagnose and start treatment early as if left untreated, this bacterial infection can spread rapidly and can be life threatening for the patient. Treatment comprises of oral antibiotics and hospitalization and I.V. antibiotics in severe cellulitis.
Causes of Cellulitis
The cause of cellulitis is one or more types of bacteria, which enter the body via a break or cut in the skin. Streptococcus and staphylococcus are the two most common types of bacteria, which are responsible for cellulitis.
As mentioned before, the lower region of the leg is the most common part of the body affected by cellulitis. Bacteria can enter through the skin which has broken from cuts, surgery, ulcer, puncture wounds, dermatitis, athlete's foot etc.
Some insect/ spider bites can also transmit the bacteria. Skin which is vulnerable, such as dry or flaky or swollen skin can also be more susceptible towards bacterial entry.
Risk Factors for Cellulitis
- Having a previous injury, fracture, cut, burn etc. increases the risk for cellulitis by allowing the bacteria to enter the body.
- Other skin conditions like eczema, chickenpox, athlete's foot, shingles etc. which cause a break in the skin increases the risk of cellulitis.
- Individuals with weak immune system due to medical conditions, such as HIV/AIDS, diabetes, chronic leukemia, liver disease, chronic kidney disease, circulation disorders etc. are at an increased risk of cellulitis.
- Individuals who use certain medications, like corticosteroids which may weaken the immune system are also at an increased risk for cellulitis.
- Individuals with previous history of cellulitis are more prone to having it again.
- Lymphedema which causes chronic swelling of the arms or legs due to which there may be cracks or fissures in the swollen tissue thus increasing the chances of entry of bacteria and cellulitis.
- Individuals who are involved in illegal intravenous drug use are at a higher risk for developing cellulitis.
- Individuals who are obese or overweight are more vulnerable for developing cellulitis, as well as having recurrent episodes of cellulitis.
Symptoms of Cellulitis
- Skin appears red and swollen.
- Skin is painful, warm and tender to touch.
- Patient will develop fever.
- If treatment is not started, then redness spreads.
- Appearance of small, red spots over the reddened skin.
- Sometimes, small blisters will form, which will burst later.
- It is important to seek immediate medical attention if the patient has fever and if his/her skin is red, swollen, and patient develops a tender rash which spreads or changes rapidly.
Investigations for Cellulitis
Physical exam is usually sufficient for diagnosis. Other tests include blood tests and wound culture etc. to find out the exact bacteria and to exclude the presence of blood clot in the leg veins, as the symptoms of cellulitis in the lower legs are similar to a clot in leg veins.
Treatment for Cellulitis
Treatment for cellulitis comprises of oral antibiotics which need to be taken for 14 days and they should be continued even if the symptoms have eased up and the patient is feeling better. The doctor will let you know if the treatment is effective or not within three days of starting an antibiotic.
If the signs and symptoms do not clear up within a few days and if the cellulitis increases and the patient has fever, then hospitalization is required and I.V. (intravenous) antibiotics are given. If the affected area is kept elevated, then it speeds up the recovery process and the swelling also subsides quickly.
It is very important to follow your doctor's instructions and take medication as instructed and complete the course of antibiotics even if the symptoms subside.
Prevention of Cellulitis
If you have any wound or cut on your skin then you need to do the following to prevent cellulitis:
- The wound should be gently cleaned with soap and water daily.
- Application of antibiotic cream/ ointment is important for protection.
- Keep a look out for signs of infection, such as pain, redness, drainage etc.
- Always keep your fingernails and toenails short.