Cellulitis - Causes, Symptoms and Treatment

Definition of Cellulitis:

Cellulitis is a spreading infection of the skin and the soft tissues underneath the skin that usually begins as a small area of tenderness, swelling, and redness on the skin. As this red area begins to spread, the person may develop a fever, sometimes with chills and sweats, and swollen lymph nodes ("swollen glands") near the area of infected skin.

You probably know that your skin has layers - three, to be exact. Cellulitis is an infection of the deepest layer, called the subcutaneous layer. It occurs when bacteria invade broken or normal skin and start to spread just under the skin or in the skin itself. This results in infection and inflammation. Inflammation is a process in which the body reacts to the bacteria. Bacteria, mainly get into the body through broken skin of any kind (such as a cut, scratch, animal bite, or a bug bite if you scratch it).

Causes of Cellulitis

Cellulitis may be caused by many different bacteria; the most common are those of the Streptococcus species. Streptococci spread rapidly in the skin because they produce enzymes that hinder the ability of the tissue to confine the infection. Although cellulitis can occur anywhere on your body, the most common location is the legs, especially near your shins and ankles. Disrupted areas of skin, such as where you've had recent surgery, cuts, puncture wounds, an ulcer, athlete's foot or dermatitis, serve as the most likely areas for bacteria to enter.

Some other Causes of Cellulitis may be:

• Insect bites and stings, animal bite, or human bite may cause cellulitis.
• Wounds occurring after exposure to fresh water may be caused by Aeromonas hydrophila, a gram-negative rod.
• History of peripheral vascular disease. Diabetes - related or ischemic ulcers are also one of the cause of cellulitis.
• In immunocompromised hosts, gram-negative rods or fungi may cause cellulitis, though fungal cellulitis is rare.
• Recent cardiovascular, pulmonary (lung), dental or other procedures.
• Use of immunosuppressive or corticosteroid medications.
• Pneumococcus may cause a particularly malignant form of cellulitis, typically in an immunocompromised host, and frequently is associated with tissue necrosis, suppuration, and blood stream invasion.

Symptoms of Cellulitis

Cellulitis frequently occurs on exposed areas of the body such as the arms , legs , and face. In advanced cases of cellulitis, red streaks (sometimes described as 'fingers') may be seen traveling up the affected area. The swelling can spread rapidly.

• cellulitis usually begins as a small, inflamed area of pain
• redness on a child's skin
• As this red area begins to spread, the child may begin to feel sick and develop a fever which may be accompanied with chills and sweats.
• swelling
• fatigue
• Swollen lymph nodes (commonly called swollen glands) are sometimes found near the area of infected skin.
• tight, glossy, "stretched" appearance of the skin
• warmth
• pain or tenderness.
• headaches
• Skin lesion/rash ( macule ):
  • Sudden onset
  • Usually with sharp borders
  • Rapid growth within the first 24 hours
• Muscle aches , pains (myalgias)

In some rare and serious cases, there may be:

• severe necrotizing subcutaneous infection.
• sepsis.
• edema
• erythema
• general malaise may accompany skin findings

Treatment of Cellulitis

Without treatment, some cases of superficial cellulitis spontaneously resolve. However, recurrences are common and can lead to serious damage to the lymph nodes. With antibiotics, such complications are uncommon.

Some of the Treatment options are:

• Penicillin is a very effective drug for the treatment of streptococcal cellulitis.

• Some doctors prefer using antibiotics that are also effective against S. aureus: dicloxacillin for mild infections, or oxacillin or nafcillin for severe infections. Cellulitis usually responds quickly to antibiotics and symptoms should ease once you have started a course of tablets. There may however be an increase in redness at the beginning of treatment before it starts to fade.

• Use warm, moist heat to relieve local tenderness. Elevate and immobilize the affected area to help reduce edema.

• In severe cases, antibiotics may be given intravenously for the first 24 to 72 hours, followed by oral antibiotics. Mild cases may only require oral antibiotics.

• In other severe cases that progress rapidly or are associated with necrosis (tissue destruction), necrotizing cellulitis - fasciitis is considered. This requires urgent surgical exploration.

• Vancomycin is indicated for those patients with suspected methicillin-resistant S. aureus infection.

• For cellulitis of the leg or arm, treatment also includes elevating the limb to reduce swelling and applying a sterile, saline-soaked dressing to aid healing and reduce pain.

• Treatment sometimes requires a stay in the hospital. This is common if antibiotics must be given intravenously, but it is also considered if you have signs of complications such as a high fever, or if it will be difficult for you to have follow-up care with a health professional.

• Some patients are allergic to penicillin drug, for them erythromycin is good for treating mild infections, and parenteral clindamycin for severe infections.

Some other Treatment Tips for curing Cellulitis fast:

• Avoid trauma, wear long sleeves and pants in high risk activities e.g. gardening.
• Keep skin clean and well moisturized, with nails well tended.
• Avoid having blood tests taken from the affected limb.
• Treat fungal infections of hands and feet early.
• Keep swollen limbs elevated during rest periods to aid lymphatic circulation.