Cellulitis Flashcards
Cellulitis
What is it?
an acute bacterial infection of the dermis and subcutaneous tissue
Cellulitis
How does the affected area present?
pain, warmth, swelling, and erythema
Blisters and bullae may form.
Cellulitis
What are some systemic presentations?
Fever, malaise, nausea, and rigors may accompany or precede the skin changes.
Cellulitis
What areas are most commonly affected?
lower limbs
upper limbs, face, ears, and trunk, can also be affected
Cellulitis
Most common causative organisms?
Streptococcus pyogenes.
Staphylococcus aureus.
Cellulitis
What do most cases of cellulitis arise fro and is therefore what is the biggest risk factor?
Most cases of cellulitis arise from bacterial infection through a break in the skin
Cellulitis
Apart from breaks in the skin, what are other risk factors?
- Lymphoedema.
- Leg oedema.
- Venous insufficiency and history of venous surgery.
- Obesity.
- Pregnancy
Cellulitis
Name some conditions that predispose people to infections?
diabetes mellitus
chronic liver or renal disease
immunocompromise
neutropenia.
Cellulitis
Acute complications of cellulitis:
4
Deep-seated infection:
- necrotising fasciitis
- Myositis
Sepsis
Subcutaneous abscesses.
Post-streptococcal nephritis.
Cellulitis
What is necrotising fasciitis?
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.
Cellulitis
What is Myositis?
inflammation of muscle due to infection
Cellulitis
Chronic complications of cellulitis:
3
- Persistent leg ulceration.
- Lymphoedema
- Recurrent cellulitis.
Cellulitis
How to diagnose?
- history
- examination
Cellulitis
What classification system do we use for pt? Describe it.
Eron classification system
Cellulitis
Although investigations arent usually necessary, what might be done?
- swab for culture
- ultrasonography
- skin biopsy
- bloods
Cellulitis
What parameters are we specifically looking for when we take bloods as an investigation?
to detect inflammation
WBC count
ESR
CRP
Cellulitis
What can we use ultrasonography for?
distinguishing nonpurulent cellulitis from cellulitis with underlying abscess and for identifying drainable fluid collection
Cellulitis
Name some differentials. (acute)
4
- DVT
- septic arthritis
- acute gout
- ruptured baker’s cyst
Cellulitis
Name some chronic conditions which may present similar to cellulitis?
2
- Varicose eczema/venous insufficiency
- contact allergic dermatitis
Cellulitis
When would we admit someone to hospital urgently?
5
- class 3 or 4 on eron
- rapidly deteriorating
- under 1 yo
- immunocompromised
- facial cellulitis
Cellulitis
How to manage people in class 1 (eron)?
high dose oral ABx
advise pt:
- analgesics for pain
- seek medical advise if deteriorating
- manage co-morbidities
Cellulitis
Which Abx to prescribe (class 1)?
no penicillin allergy
Flucloxacillin
Cellulitis
Which Abx to prescribe (class 1)?
penicillin allergy
- Clarithromycin
- Doxycycline
Cellulitis
Which Abx to prescribe (class 1)?
pregnant
Erythromycin
