[10] Cellulitis Flashcards

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1
Q

What is cellulitis?

A

A bacterial infection involving the dermis and subcutaneous fat

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2
Q

What causes cellulitis?

A

Bacteria entering the skin

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3
Q

How can bacteria enter the skin?

A

Via a cut, abrasion or break in the skin

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4
Q

What are the most common causative bacteria in cellulitis?

A
  • Group A strep

- Staphylococcus

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5
Q

What are the risk factors for cellulitis?

A
  • Immunocompromisation
  • Previous erysipelas or cellulitis
  • Venous insufficiency
  • Elderly age
  • Alcoholism
  • IV drug use
  • Overweight/obesity
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6
Q

Where is cellulitis most commonly seen?

A

In the lower limbs unilaterally

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7
Q

How does skin affected by cellulitis appear?

A

Erythema, pain, swelling and warmth of affected skin

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8
Q

What are the systemic symptoms of cellulitis?

A

Fever and malaise

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9
Q

What is seen in cellulitis that has progressed to the lymphatic system?

A

Red lines streaking away from the cellulitic area

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10
Q

How can cellulitis be differentiated from erysipelas?

A

Cellulitis has poorly demarcated borders compared to the sharp borders of erysipelas

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11
Q

How is cellulitis diagnosed?

A

Clinically

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12
Q

What investigation may be required in atypical, refractive or serious cases of cellulitis?

A

Swabs from potential portals of entry

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13
Q

What other investigations could be considered in cellulitis if concerned about a foreign body in situ or bone involvement?

A
  • X-rays
  • CT scans
  • MRI (not if metal foreign body)
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14
Q

If bullae or abscesses form in cellulitis what investigation can be performed?

A

Culture of fluids

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15
Q

What investigations may be required in recurrent episodes of cellulitis?

A

Investigations to exclude underlying causes e.g. DM or immunodeficiency

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16
Q

What are the differentials for cellulitis?

A
  • Necrotising fasciitis
  • Superficial thrombophlebitis
  • DVT
  • Gout
  • Dermatitis
  • Varicose eczema
17
Q

What are the general supportive management options in cellulitis?

A
  • Rest
  • Elevate affected limb
  • Analgesia
  • Manage underlying conditions
  • Clean any wound sites
  • Use emollients
18
Q

What is the first line antibiotic in uncomplicated cellulitis?

A

Flucloxacillin 500mg QDS

19
Q

What antibiotic can be given for cellulitis in patients with penicillin allergy?

A

Erytromycin 500mg QDS

20
Q

What antibiotic is often given as second-line in cellulitis?

A

Clindamycin

21
Q

How long is antibiotic therapy given for?

A

7 days (increase to 10-14 if needed)

22
Q

When should patients with cellulitis be referred to hospital?

A
  • Rapidly worsening infection
  • Systemic illness or vomiting
  • Facial infection
  • Immunocompromised
  • Under 1 year old
23
Q

What are the potential complications of cellulitis?

A
  • Abscess formation
  • Fasciitis
  • Sepsis
  • Thrombophlebitis/lymphangitis
  • Necrotising fasciitis
  • Osteomyelitis