From the Guidelines
Cellulitis is characterized by signs of inflammation, including warmth, erythema, pain, lymphangitis, and frequently systemic upset with fever and raised white blood cell count, as reported in the 2018 WSES/SIS-E consensus conference 1. The infection typically affects the lower extremities, although it can affect other areas, and is caused by bacteria, usually streptococcus or staphylococcus, entering through breaks in the skin. Key signs of cellulitis include:
- Erythema (redness)
- Tenderness
- Induration (swelling)
- Warmth
- Pain in the affected area
- Systemic symptoms such as fever, chills, fatigue, and swollen lymph nodes near the infection site
- Red streaks extending from the infected area, indicating spreading infection through the lymphatic vessels
- Blisters or skin ulcers in severe cases
- Irregular borders, not sharply defined, which helps distinguish it from other skin conditions It is essential to seek medical attention promptly if these signs are noticed, as untreated cellulitis can lead to serious complications, including bloodstream infection (sepsis) 1.
From the Research
Signs of Cellulitis
The signs of cellulitis include:
- Erythema (redness) over the affected area 2, 3, 4, 5, 6
- Swelling over the affected area 2, 3, 4, 5, 6
- Warmth over the affected area 2, 3, 4, 5, 6
- Tenderness over the affected area 2, 3, 4, 5, 6
- Pain over the affected area 5
- Fever 6
- A circumscribed erythema with a raised border 6
Clinical Presentation
Cellulitis is a clinical diagnosis based on the history of present illness and physical examination 3, 4, 5. The clinical presentation of cellulitis can be difficult to diagnose due to a number of infectious and non-infectious clinical mimickers such as venous stasis dermatitis, contact dermatitis, eczema, lymphedema, and erythema migrans 5.
Diagnosis
The diagnosis of cellulitis is based primarily on history and physical examination 3. Microbiological diagnosis is often unobtainable due to poor sensitivity of culture specimens 5.