CELLULITIS Flashcards
What is cellulitis?
- Break in skin and infection with S. aureus or Strep. Pyogenes.
- Transmitted by: contact with infected individual/objects (contagious).
Erysipelas vs cellulitis
Erysipelas is a superficial infection, affecting the upper layers of the skin, while cellulitis affects the deeper tissues.
Lesions are more superficial in erysipelas and have a well-defined, raised margin.
Symptoms of cellulitis
- Red skin
- Swelling
- Hot
- Pain
- Calor, dolor, tumor, rubor
Eron classification
- Used to class severity
- Greater than class III – hospital admission.
Class I
no signs of systemic toxicity or uncontrolled comorbidities
- Managed in primary care
Class II
Class II – a person either systemically unwell or systemically well but with a comboribity
e.g. arterial disease, chronic venous insufficiency, morbid obesity
which may complicate or delay resolution of infection
- Suitable for short term (up to 48h) hospitalisation and discharge on outpatient parenteral abx therapy
Class III
significant systemic upset
e.g. acute confusion, tachycardia, hypotension
or unstable comorbidities that may interfere with response to treatment or limb threatening infection due to vascular compromise
Class IV
sepsis, or severe life-threatening infection
e.g. necrotising fasciitis
- Class III IV = urgent hospital admission
Treatment
- Flucloxacillin 0.5–1 g 4 times a day for 5–7 days then review.
- Penicillin Allergy: Clarithromycin 500mg BD/ Erythromycin 500mg QDS/ Doxycycline 200mg on day 1, then 100mf OD (all for 5-7 days)
Treatment if infection is near the eyes or nose
- Co-Amoxiclav
625mg TDS for 7 days then review - Penicillin Allergy: Clarithromycin AND metronidazole
clarith 500mg BD + metro 400mg TDS for 7 days
when may a trial of abx prophylaxis be considered for cellulitis or erysipelas
Pt treated in hospital or under specialist advice for at least 2 separate episodes in the previous 12 months
review every 6 months
