Cellulitis Flashcards

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1
Q

Define Cellulitis?

A

Acute non-purulent spreading infection of the subcutaneous tissue, causing overlying skin inflammation

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2
Q

What is the aetiology of Cellulitis?

A

Often results from:

  • Penetrating Injury
  • Local Lesions (e.g. insect bits)
  • Fissuring (e.g. anal fissures)

This allows pathogenic bacteria to enter the skin

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3
Q

What are the most common organisms that enter the skin in Cellulitis?

A

Streptococcus Pyogenes
Staphylococcus Aureus
Beware of MRSA

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4
Q

What is Cellulitis of the orbit (orbital Cellulitis) is usually caused by?

A

Haemophilus Influenzae

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5
Q

What are the risk factors for Cellulitis?

A

Skin Break
Poor Hygeine
Poor Vascularisation of tissue (e.g. due to diabetes mellitus)

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6
Q

What is the epidemiology of Cellulitis?

A

Very Common

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7
Q

What are the general history features of Cellulitis?

A

History of cut, scratch or injury

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8
Q

What are the presenting symptoms of Periorbital Cellulitis?

A

Painful swollen red skin around the eye

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9
Q

What are the presenting symptoms of Orbital Cellulitis?

A

Painful or limited eye movements, visual impairment

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10
Q

What are the signs of Cellulitis caused by Lesion on physical examination?

A

Erythema
Oedema
Warm tender indistinct margins
Pyrexia - may suggest systemic spread

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11
Q

What is important to remember with Cellulitis on physical examination?

A

Exclude the presence of an abscess (aspirate if pus suspected)

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12
Q

What are the signs of Periorbital Cellulitis on physical examination?

A

Swollen Eye Lids

Conjuctival Infection

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13
Q

What are the signs of Orbital Cellulitis on physical examination?

A

Proptosis
Impaired visual acuity and eye movements
Test for RAPD, visual acuity and colour vision

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14
Q

What bloods would you do for Cellulitis?

A

WCC

Blood Culture

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15
Q

What investigation would you do for discharge for Cellulitis?

A

Sample and send for MC&S

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16
Q

When do we do an Aspiration for Cellulitis?

A

If pus is suspected

17
Q

When do we do a CT/MRI for Cellulitis?

A

If orbital Cellulitis is suspected (helps assess posterior spread of infection)

18
Q

What is the medical management plan for Cellulitis?

A
Oral penicillins (e.g. flucloxacillin) or tetracyclines are effective 
If hospital-acquired - treat empirically based on local guidelines and change depending on the sensitivity of cultured organisms
19
Q

What is the surgical management plan for Cellulitis?

A

Orbital decompression may be needed in orbital cellulitis (EMERGENCY)

20
Q

What do we do for an Abscess in Cellulitis?

A

Aspirate
Incision and drainage
Excised completely

21
Q

What are the possible complications of Cellulitis?

A

Sloughing of overlying skin
Orbital Cellulitis - may cause permanent loss of vision, spread to the brain, abscess formation, meningitis, cavernous sinus thrombosis