Skin and soft tissue infections Flashcards
What is cellulitis?
Cellulitis is an infection of the skin and underlying soft tissues. It occurs when bacteria breach the skin barrier, often due to trauma, eczema, fungal infections, or ulcers.
What are the classic skin changes seen in cellulitis?
- Erythema (redness)
- Warm or hot to touch
- Tense and thickened skin
- Oedematous (swelling)
- Bullae (fluid-filled blisters)
- Golden-yellow crust, suggesting Staphylococcus aureus infection
What systemic signs can accompany cellulitis?
Patients may present with signs of sepsis, including fever, chills, tachycardia, and hypotension.
What are the common causes of cellulitis?
- Staphylococcus aureus
- Group A Streptococcus (e.g., Streptococcus pyogenes)
- Group C Streptococcus (e.g., Streptococcus dysgalactiae)
What should be considered in cases of cellulitis with recurrent hospital admissions or antibiotic use?
Methicillin-resistant Staphylococcus aureus (MRSA) should be considered in these cases.
What is the Eron Classification used for?
The Eron Classification assesses the severity of cellulitis based on systemic toxicity and comorbidities.
What are the Eron Classification categories for cellulitis?
- Class 1: No systemic toxicity or comorbidity
- Class 2: Systemic toxicity or comorbidity
- Class 3: Significant systemic toxicity or significant comorbidity
- Class 4: Sepsis or life-threatening infection
How is cellulitis managed in Class 3 and 4 cases?
These cases require admission for intravenous antibiotics. Admission is also considered for frail, very young, immunocompromised patients, and those with facial or orbital cellulitis.
What is the first-line treatment for cellulitis?
Flucloxacillin is the first-line antibiotic, effective against Staphylococcus aureus and other gram-positive cocci. It can be given either orally or intravenously.
What are some alternative antibiotics for cellulitis?
- Clarithromycin
- Clindamycin
- Co-amoxiclav (especially for cellulitis near the eyes or nose)
