Cellulitis Flashcards
What is cellulitis?
bacterial infection of dermis and subcutaneous fat
What microorganisms cause cellulitis?
beta haemolytic streptococcus
staphylococcus aureus
How does cellulitis present?
swelling tenderness redness warmth no distinct margins
Where is normally affected by cellulitis?
lower limbs
usually unilateral
What are the signs and symptoms of cellulitis?
red painful hot swollen tender skin spreading rapidly
fever, malaise, nausea, shivering and rigors
inflamed regional lymph nodes
What are some risk factors of DVT?
diabetes mellitus
hospital stays
elderly
oedema
What are the risk factors for rapid progression of cellulitis?
diabetes mellitus chronic liver/renal disease immunocompromise neutropenia chickenpox alcohol misuse neuroopathy
What are the investigations for cellulitis?
normal investigations swab area of skin XR if concerned re gas formation/osteomyelitis USS for abscess lactate (sepsis 6) skin biopsy
How is cellulitis classified?
Eron classification
Class I - no signs of systemic toxicity and no uncontrolled co-morbidities
Class II - systemically unwell or systemically well with comorbidity that may complicate (IV Abx, hospital admission for 48hrs)
Class III - significant systemic upset eg acute confusion, tachycardia, tachypnoea, hypotension or unstable co-morbidities or limb-threatening infection due to vascular compromise (IV Abx and hospital admission)
Class IV - sepsis/severe life-threatening infection eg necrotising fasciitis (IV Abx +/- debridement and hospital admission)
Why would someone be admitted to hospital for cellulitis?
severe/rapidly deteriorating cellulitis very young/frail immunocompromised significant lymphoedema facial cellulitis orbital/preorbital cellulitis
What is the treatment for cellulitis?
mark area and assess if spreading
Abx based on local guidelines
Flucloxicillin first line
(clarithromycin/clindamycin if penicillin allergic)
What is the management for cellulitis?
analgesia
drink adequate fluids
elevate legs
avoid compression garments
What are the complications of cellulitis?
damage to lymphatic drainage chronic swelling necrotising fasciitis septic abscess sepsis myositis post-strep nephritis
What is the prevention for cellulitis?
weight management
use of emollients to prevent drying and cracking of skin
