Cellulitis

Question 1

What is cellulitis?

Answer 1

A bacterial infection that affects the dermis and deeper subcutaneous tissues

Question 2

What is the most common causes of cellulitis?

Answer 2

Streptococcus pyogenes
Staphylococcus aureus

Question 3

What are the risk factors for cellulitis?

Answer 3

Break in the cutaneous barrier
Immunocompromise
Other skin conditions
History of cellulitis
Obesity
Venous insufficiency
Lymphoedema

Question 4

What are the clinical features of cellulitis?

Answer 4

Red, hot, painful area of the skin
Systemic upset
- Fever
- Malaise
- Nausea

Question 5

How is cellulitis diagnosed?

Answer 5

Cellulitis is a clinical diagnosis
Investigations that may be helpful:
- FBC and CRP
- Swab

Question 6

What is the Eron classification system of cellulitis?

Answer 6

Class 1
- No signs of systemic toxicity
- No uncontrolled comorbidities
Class 2
- Systemically unwell or systemically well with significant comorbidities that may delay resolution
Class 3
- Significant systemic upset or unstable comorbidities or limb threatening infection
Class 4
- Sepsis

Question 7

When is admission required for cellulitis?

Answer 7

Admission is considered to Eron class 2, and required for class 3 and 4

Question 8

What is the first line antibiotic for cellulitis?

Answer 8

Flucloxacillin

Question 9

What are the criteria for urgent hospital admission and IV antibiotics?

Answer 9

Eron class 3 or 4
Severe or rapidly deteriorating cellulitis
Very young or frail
Immunocompromised
Significant lymphoedema
Facial cellulitis
Suspected orbital or periorbital cellulitis

Question 10

What is the first line antibiotic for cellulitis if near the eyes or nose?

Answer 10

Co-amoxiclav

Question 11

What antibiotics can be used for cellulitis if the patient is penicillin allergic?

Answer 11

Clarithromcin
Erythromycin (in pregnancy)
Doxycycline

Question 12

What antibiotic is given in addition to regular treatment for suspected MRSA?

Answer 12

Vancomycin