Can cellulitis cause bullae (blisters)?

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Last updated: February 19, 2025 • View editorial policy

From the Guidelines

Cellulitis and Bullae Formation

Yes, cellulitis can cause blisters. According to the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1, cellulitis can lead to the formation of vesicles and bullae filled with clear fluid, which are common in inflamed skin. These fluid-filled sacs can be painful and may rupture, leading to further infection.

Clinical Presentation and Treatment

The clinical presentation of cellulitis includes rapidly spreading areas of edema, redness, and heat, sometimes accompanied by lymphangitis and inflammation of the regional lymph nodes 1. Systemic manifestations are usually mild, but fever, tachycardia, confusion, hypotension, and leukocytosis are sometimes present and may even occur hours before the skin abnormalities appear.

Treatment of cellulitis typically involves a 7-10 day course of oral antibiotics, such as cephalexin or dicloxacillin, and in some cases, may require hospitalization for intravenous antibiotics. It is essential to seek medical attention if you experience any symptoms of cellulitis, as prompt treatment can help prevent complications, including blister formation. If blisters do form, it is crucial to keep the area clean and dry to prevent further infection, and to avoid popping or draining the blisters, as this can lead to further complications.

Severe Cases and Potential Complications

In severe cases, cellulitis can lead to more serious complications, such as necrotizing fasciitis, which requires emergent surgical evaluation for both diagnostic and therapeutic reasons 2. Other clues to potentially severe deep soft-tissue infection include pain disproportionate to the physical findings, violaceous bullae, cutaneous hemorrhage, skin sloughing, skin anesthesia, rapid progression, and gas in the tissue.

Antibiotic Resistance and Treatment

The increasing prevalence of antibiotic-resistant strains, such as methicillin-resistant Staphylococcus aureus (MRSA), poses a challenge in the treatment of cellulitis 2. Empirical treatment with antibiotics effective against MRSA, such as vancomycin, linezolid, or daptomycin, may be necessary in severe cases or in patients who do not respond to initial empirical therapy.

From the Research

Cellulitis and Bullae (Blisters)

  • There is no direct evidence in the provided studies that cellulitis can cause bullae (blisters) 3, 4, 5, 6, 7.
  • The studies primarily focus on the diagnosis, management, and treatment of cellulitis, as well as its clinical manifestations and complications.
  • Common symptoms and signs of cellulitis mentioned in the studies include erythema, swelling, warmth, tenderness, and pain, but bullae (blisters) are not specifically mentioned as a symptom or complication of cellulitis 3, 4, 5, 6, 7.
  • The studies do discuss various dermatologic conditions that can mimic cellulitis, such as venous stasis dermatitis, contact dermatitis, and eczema, but do not mention bullae (blisters) as a characteristic of these conditions either 3, 4, 5, 6, 7.

References

Research

Cellulitis: diagnosis and management.

Dermatologic therapy, 2011

Research

Cellulitis: A Review.

JAMA, 2016

Research

Cellulitis.

Infectious disease clinics of North America, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.