Cellulitis

Question 1

What is cellulitis?

Answer 1

It is defined as a bacterial infection that affects the dermis and deeper subcutaneous tissues

Question 2

Which area of the body is most commonly affected by cellulitis?

Answer 2

Shins

Question 3

What are the three bacterial organisms associated with cellulitis?

Answer 3

Streptococcus Pyogenes

Staphylococcus Aureus

Streptococcus Dysgalactiae

Question 4

What is the most common bacterial organism associated with cellulitis?

Answer 4

Streptococcus Pyogenes

Question 5

What classification system is used in cellulitis?

Answer 5

Eron Classification System

Question 6

What are the four classifications of cellulitis?

Answer 6

Cellulitis Class One

Cellulitis Class Two

Cellulitis Class Three

Cellulitis Class Four

Question 7

What is cellulitis class one?

Answer 7

It is defined as infection in which there are no signs of systemic toxicity, and the individual has no uncontrolled co-morbidities

Question 8

What cellulitis class two?

Answer 8

It is defined as infection in which the individual is systemically unwell or systemically well, however with a co-morbidity which may complicate or delay resolution of infection – including peripheral arterial disease, chronic venous insufficiency or morbid obesity

Question 9

What is cellulitis class three?

Answer 9

It is defined as infection in which the individual has significant systemic upset, with features of acute confusion, tachycardia, tachypnoea, hypotension

OR

It is defined as an infection in which the individual has unstable co-morbidities that may interfere with a response to treatment

OR

It is defined as an infection in which there is a limb-threatening infection due to vascular compromise

Question 10

What is cellulitis class four?

Answer 10

It is defined as infection in which the individual has developed sepsis or a severe life threatening infection

Question 11

What are the four risk factors associated with cellulitis?

Answer 11

Skin Trauma

Eczematous Skin

Skin Ulceration

Fungal Nail Infections

Question 12

Are the clinical features of cellulitis unilateral or bilateral?

Answer 12

Unilateral

Question 13

What are the seven clinical features of cellulitis?

Answer 13

Fever > 38C

Erythematous Skin

Warm Skin

Thickened Skin

Oedematous Skin

Blisters & Bullae

Golden Yellow Crust

Question 14

What are bullae?

Answer 14

They are defined as fluid filled blisters

Question 15

What does golden yellow crust indicate in cellulitis?

Answer 15

It indicates that the infection is associated with staph. aureus

Question 16

How is cellulitis diagnosed?

Answer 16

Clinically

In primary care, no further investigations are required and antibiotics should be administered immediately

Question 17

In which circumstance are investigations required to investigate cellulitis? Which investigation should be conducted?

Answer 17

When individuals are admitted to secondary care, due to suspected septicaemia

Blood cultures

Question 18

What is the first line management option of mild/moderate cellulitis?

Answer 18

Beta Lactam Antibiotics

Question 19

Name the beta-lactam antibiotic used to manage cellulitis

Answer 19

Flucloxacillin

Question 20

What is the second line management option of mild/moderate cellulitis?

Answer 20

Marcolide Antibiotics

Question 21

Name the three macrolide antibiotics used to manage cellulitis

Answer 21

Erythromycin

Clarithromycin

Doxycycline

Question 22

What antibiotic is used to manage cellulitis in pregnancy?

Answer 22

Erythromycin

Question 23

In which seven circumstances is secondary care admission of cellulitis recommended?

Answer 23

Cellulitis Class III & IV

Severe Or Rapidly Deteriorating Cellulitis

Significant Lymphoedema

Facial Cellulitis Or Periorbital Cellulitis

Individuals < 1 Years Old

Frail Patients

Immunocompromised

Question 24

Why is secondary care admission requried to manage cellulitis?

Answer 24

IV antibiotic administration

Question 25

Name four IV antibiotics used to manage cellulitis

Answer 25

IV co-amoxiclav

IV clindamycin

IV cefuroxime

IV ceftriaxone