Cellulitis

Question 1

what are the main causative organisms of cellulitis?

Answer 1

staphylococcus pyogenes

staphylococcus aureus

Question 2

what are risk factors for cellulitis?

Answer 2

Hx cellulitis 
tine pedis
significant lymphedema 
immunosuppression 
venous insufficiency 
diabetes mellitus

Question 3

what is cellulitis?

Answer 3

infection and inflammation of the deep dermis and subcutaneous tissue

Question 4

what is the 1st line treatment for cellulitis?

Answer 4

IV flucloxacillin 
(oral if Eron classification I)

Co-amoxiclav if severe

Question 5

how is severity of cellulitis classified?

Answer 5

Eron classification
I - no systemic upset
II - mild systemic upset or co-morbidity that would prolong healing
III - significant systemic upset and co-morbidity that complicates recovery or limb threatening infection due to vascular insufficiency
IV - sepsis or life threatening infection

Question 6

when would you admit a patient with cellulitis?

Answer 6

Eron classification III or IV 
< 1 yr old or frail 
immunosuppressed 
rapidly deteriorating cellulitis 
facial cellulitis or periorbital cellulitis

Question 7

what investigations would you carry out if a patient had cellulitis?

Answer 7

usually just a clinical diagnosis but if they were in hospital you could do a blood test and blood culture
skin swab and skin aspirate if source of infection is a breach in the skin

Question 8

what treatment would you give if the patient was penicillin allergic?

Answer 8

erythromycin or clarithromycin or doxycycline