Cellulitis

Question 1

Organisms which commonly cause cellulitis

Answer 1

Streptococcus pyogenes
Staphylcoccus aureus

Question 2

Common features of cellulitis

Answer 2

• Common on shins - unilateral
• erythema
• well-defined margins
• blisters/ bullae
• swelling
• systemic upset (fever/malaise/nausea)

Question 3

Describe the 4 stages of the Eron classification used in Cellulitis

Answer 3

I - no systemic upset
- no uncontrolled comorbidity

II - systemically well or unwell
+ comorbidity impacting infection

III - systemic upset + unstable comorbidity impacting treatment/resolution of infection

IV - sepsis syndrome +/- severe life-threatening infection such as necrotizing fasciitis

Question 4

Who with cellulitis should be admitted to hospital for IV antibiotics?

Answer 4

• Eron Class III or IV
• rapidly deteriorating cellulitis (extensive areas of skin).
• Extremes of age
• immunocompromised.
• significant lymphoedema.
• facial/periorbital cellulitis

Question 5

Management of cellulitis

Answer 5

Low severity - oral flucloxacillin
Pen allergy: clarithromycin, erythromycin (in pregnancy) or doxycycline

High severity
- IV co-amoxiclav, clindamycin, cefuroxime or ceftriaxone