Cellulitis Flashcards

1
Q

Cellulitis

What is it?

A

an acute bacterial infection of the dermis and subcutaneous tissue

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2
Q

Cellulitis

How does the affected area present?

A

pain, warmth, swelling, and erythema

Blisters and bullae may form.

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3
Q

Cellulitis

What are some systemic presentations?

A

Fever, malaise, nausea, and rigors may accompany or precede the skin changes.

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4
Q

Cellulitis

What areas are most commonly affected?

A

lower limbs

upper limbs, face, ears, and trunk, can also be affected

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5
Q

Cellulitis

Most common causative organisms?

A

Streptococcus pyogenes.
Staphylococcus aureus.

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6
Q

Cellulitis

What do most cases of cellulitis arise fro and is therefore what is the biggest risk factor?

A

Most cases of cellulitis arise from bacterial infection through a break in the skin

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7
Q

Cellulitis

Apart from breaks in the skin, what are other risk factors?

A
  • Lymphoedema.
  • Leg oedema.
  • Venous insufficiency and history of venous surgery.
  • Obesity.
  • Pregnancy
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8
Q

Cellulitis

Name some conditions that predispose people to infections?

A

diabetes mellitus
chronic liver or renal disease
immunocompromise
neutropenia.

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9
Q

Cellulitis

Acute complications of cellulitis:

4

A

Deep-seated infection:
- necrotising fasciitis
- Myositis

Sepsis

Subcutaneous abscesses.

Post-streptococcal nephritis.

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10
Q

Cellulitis

What is necrotising fasciitis?

A

a destructive and rapidly progressive soft tissue infection that involves the deep subcutaneous tissues and fascia

characterized by extensive necrosis and gangrene of the skin and underlying structures.

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11
Q

Cellulitis

What is Myositis?

A

inflammation of muscle due to infection

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12
Q

Cellulitis

Chronic complications of cellulitis:

3

A
  • Persistent leg ulceration.
  • Lymphoedema
  • Recurrent cellulitis.
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13
Q

Cellulitis

How to diagnose?

A
  • history
  • examination
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14
Q

Cellulitis

What classification system do we use for pt? Describe it.

A

Eron classification system

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15
Q

Cellulitis

Although investigations arent usually necessary, what might be done?

A
  • swab for culture
  • ultrasonography
  • skin biopsy
  • bloods
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16
Q

Cellulitis

What parameters are we specifically looking for when we take bloods as an investigation?

A

to detect inflammation

WBC count
ESR
CRP

17
Q

Cellulitis

What can we use ultrasonography for?

A

distinguishing nonpurulent cellulitis from cellulitis with underlying abscess and for identifying drainable fluid collection

18
Q

Cellulitis

Name some differentials. (acute)

4

A
  • DVT
  • septic arthritis
  • acute gout
  • ruptured baker’s cyst
19
Q

Cellulitis

Name some chronic conditions which may present similar to cellulitis?

2

A
  • Varicose eczema/venous insufficiency
  • contact allergic dermatitis
20
Q

Cellulitis

When would we admit someone to hospital urgently?

5

A
  • class 3 or 4 on eron
  • rapidly deteriorating
  • under 1 yo
  • immunocompromised
  • facial cellulitis
21
Q

Cellulitis

How to manage people in class 1 (eron)?

A

high dose oral ABx

advise pt:
- analgesics for pain
- seek medical advise if deteriorating
- manage co-morbidities

22
Q

Cellulitis

Which Abx to prescribe (class 1)?

no penicillin allergy

A

Flucloxacillin

23
Q

Cellulitis

Which Abx to prescribe (class 1)?

penicillin allergy

A
  • Clarithromycin
  • Doxycycline
24
Q

Cellulitis

Which Abx to prescribe (class 1)?

pregnant

A

Erythromycin