From the Guidelines
Cellulitis is characterized by local signs of inflammation, such as warmth, erythema, pain, lymphangitis, and frequently systemic upset with fever and raised white blood cell count, typically affecting the lower extremities. The clinical manifestations of cellulitis include redness, swelling, and pain in the affected area, which may have poorly defined borders and can spread outward from the initial site of infection. The skin may appear glossy or tight, and red streaks may extend from the affected area toward nearby lymph nodes. Blisters, skin dimpling, or areas that look like an orange peel texture can develop. Symptoms often include fever, chills, fatigue, and swollen lymph nodes near the infection.
Some key points to consider in the clinical manifestations of cellulitis include:
- The infection can occur anywhere on the body, but it most commonly affects the lower legs 1
- The redness and swelling can be accompanied by warmth, pain, and tenderness to the touch 1
- Systemic symptoms such as fever, chills, and fatigue can occur, especially if the infection is severe or spreading 1
- The infection can be caused by bacteria, usually streptococcus or staphylococcus, which enter through breaks in the skin such as cuts, scrapes, or skin conditions like eczema 1
It is essential to seek medical attention promptly if symptoms of cellulitis are noticed, as the infection requires antibiotic treatment, typically with medications like cephalexin, dicloxacillin, or clindamycin for 5-10 days 1. Without treatment, the infection can spread deeper into the body and become serious. Proper wound care is also crucial in preventing cellulitis, especially in individuals with underlying skin conditions or compromised immune systems 1.
From the Research
Clinical Manifestations of Cellulitis
The clinical manifestations of cellulitis include:
- Erythema (redness of the skin) 2, 3, 4, 5, 6
- Swelling 2, 3, 4, 5, 6
- Warmth 2, 3, 4, 5, 6
- Tenderness 2, 3, 4, 5, 6
- Pain 3, 6
Diagnosis and Differential Diagnosis
Cellulitis is a clinical diagnosis based on history and physical examination 2, 3, 4, 5, 6. The diagnosis can be challenging due to the presence of clinical mimickers such as:
- Venous stasis dermatitis 2, 6
- Contact dermatitis 2, 6
- Deep vein thrombosis 2
- Panniculitis 2
- Eczema 6
- Lymphedema 6
- Erythema migrans 6
Treatment and Management
Treatment of cellulitis typically involves oral antibiotics, with the choice of antibiotic depending on the suspected causative organism 2, 3, 4, 6. In some cases, antimicrobial prophylaxis may be effective in preventing recurrent cellulitis 4. A holistic patient assessment, skin assessment, and thorough clinical history are important in the diagnosis and management of cellulitis 5.