Cellulitis Flashcards
What is cellulitis?
A bacterial infection of the dermis and deeper subcutaneous tissue
What does cellulitis require for entry?
A breach in the skin barrier and point of entry for bacteria
What are risk factors for cellulitis?
- Age
- Immunocompromised-Diabetes
- Predisposing skin condition e.g. ulcers, pressure sores, trauma, lymphoedema
What are possible causes of cellulitis?
- Streptococcus pyogenes-main cause
- Staphylococcus aureus
How can cellulitis present?
- Unilateral leg symptoms
- Hot, Red, Swollen, Painful
- Poorly demarcated margins
- Lymphadenopathy
How is cellulitis diagnosed?
- Clinical history and examination
* Swab the wound
What would a yellow crust suggest?
Yellow crust suggests staph aureus infection
What is the classification for cellulitis?
Eron classification
What is class 1 of the Eron classification?
No systemic toxicity or uncontrolled comorbidity
What is class 2 of the Eron classification?
Systemic toxicity or comorbidity
(systemically unwell or systemically well but with a co-morbidity
What is class 3 of the Eron classification?
Significant systemic toxicity and comorbidity
(confusion, tachycardia, tachypnoea, hypotension, or unstable co-morbidities that may interfere with a response to treatment, or a limb-threatening infection due to vascular compromise)
What is class 4 of the Eron classification?
Sepsis syndrome or severe life threatening infection (necrotizing fasciitis)
What are possible complications of cellulitis?
- Abscess
- Sepsis
- Necrotising Fasciitis
What is the management of Eron class 1 cellulitis?
Flucloxicillin
What is the management of cellulitis if near the nose or mouth?
Co-amoxiclav
What is the management of eron class 3 or 4 cellulitis?
Admit
Oral/IV co-amoxiclav, oral/IV clindamycin, IV cefuroxime or IV ceftriaxone
What is the management of cellulitis if the patient is allergic to penicillin?
Clarithromycin, erythromycin or Doxycycline
What is the management of cellulitis in pregnancy if allergic to penicillin?
Erythromycin
What systmeic symptoms might present in someone with cellulitis?
Fever
Malaise
Nausea
When would you admit somoene for IV antibiotics for cellulitis?
Has Eron Class III or Class IV cellulitis.
Has severe or rapidly deteriorating cellulitis
Is very young (under 1 year of age) or frail.
Is immunocompromized.
Has significant lymphoedema.
Has facial cellulitis (unless very mild) or periorbital cellulitis.
