Cellulitis

Question 1

Causes? (2)

Answer 1

Step pyogenes (Group A streptococcus)
Staph.aureus

Question 2

Features? (3)

Answer 2

commonly occurs on the shins
erythema, pain, swelling
there may be some associated systemic upset such as fever

Question 3

What classification is used as a guide for Mx?

Answer 3

Eron classification

Question 4

Eron classification?

Answer 4

Class I: There are no signs of systemic toxicity and the person has no uncontrolled co-morbidities

Class II: The person is either systemically unwell or systemically well but with a co-morbidity (for example peripheral arterial disease, chronic venous insufficiency, or morbid obesity) which may complicate or delay resolution of infection

Class III: The person has significant systemic upset such as acute confusion, tachycardia, tachypnoea, hypotension, or unstable co-morbidities that may interfere with a response to treatment, or a limb-threatening infection due to vascular compromize

Class IV: The person has sepsis syndrome or a severe life-threatening infection such as necrotizing fasciitis

Question 5

What are the following recommendation for admission of IV antibiotics? (6)

Answer 5

Eron class III and IV
Has severe rapidly deteriorating cellulitis (e.g. extensive areas of the skin)
Is very young (under 1 yr age) or frail
Immunocompromised
Significant lymph-oedema
Facial cellulitis or periorbital cellulitis

Question 6

Perioribital cellulitis?

Answer 6

fever, eyelid swollen, redness, proptosis (exophthalmos)

Question 7

Rx for mild/moderate cellulitis?

Rx for severe cellulitis?

Answer 7

Flucloxacillin

IV flucloxacillin + benzylpencillin