1: Cellulitis Flashcards
Define cellulitus
Infection of deep dermis and subcutaneous tissue
What is the difference between cellulitis and erysipelas
Cellulitis = deep dermis and SC tissue Erysipelas = superficial dermis
what causes cellulitis most commonly
Staphylococcus aureus
what else can cause cellulitis
Group A Streptococcus
what are 5 RF for cellulitis
- Diabetes
- Peripheral arterial disease
- Chronic venous insufficiency
- Chronic lymphedema
- Obesity
how does cellulitis present
Erythema of the skin and swelling
- May present with fever
where is cellulitis most common
Over shins
how is cellulitis investigated
inspection
- may perform wound swab if infection
what classification system is used for cellulitis
ERON classification system
what is ERON classification I
- No systemic upset
- No uncontrolled co-morbidities
what is ERON class 2
- Systemic upset
- No systemic upset, but co-morbidities that may complicate or delay healing
what is ERON class 3
- Significant systemic upset (hypotension, tachycardia)
- Severe unstable co-morbidities = limb-threatening infection
what is ERON class 4
- Sepsis or necroitisng-fascitis = life-threatening
when are patients admitted for IV antibiotics with cellulitis
- Eron class 3 or 4
- Immunocompromised
- Under 1 or Frail
- Peri-orbital cellulitus
- Lymphedema
How is non-severe cellulitis managed
7d Flucloxacillin PO
How is severe cellulitis managed
co-amoxiclav or cephalosporin
What are complications of cellulitis
- Orbital cellulitus
- Sepsis
- Necrotising fasciitis
what is orbital cellulitis
Infection fat and muscle behind the eye
what does orbital cellulitis require
emergency admission to hospital
what is preseptal cellulitis
infection tissues anterior to the eye
what age usually gets orbital cellulitis
7-12 year-olds
what are 4 risk factors for orbital cellulitis
- Facial infection
- Childhood
- Previous sinus infection
- Lack of Hib vaccine
what is a risk factor for peri-orbital cellulitis
Bites or injury to the eyelid
how does orbital cellulitis present
- Ophthalmoplegia
- Severe ocular pain
- Visual disturbance
- Proptosis
- Eyelid oedema and ptosis
how is pre-septal cellulitis differentiated from orbital cellulitis
In pre-septal (peri-orbital) there is no opthalmogplegia, pain with eye movements
what imaging is required in orbital cellulitus
CT contrast
how is orbital cellulitus managed
IV antibiotics
what is a skin abscess
collection pus in dermis and SC tissue
what causes skin abscesses
- staphylococcus aureus
how do abscesses present
- hot tender erythematous mass
how are abscesses managed
- incision and drainage
- leave wound to heal by secondary intention
