From the Guidelines
Cellulitis is characterized by diffuse, superficial, spreading skin infections, presenting with signs such as redness, warmth, tenderness, and edema, and its primary treatment is antimicrobial therapy. The affected area typically becomes red, swollen, warm to the touch, and painful or tender, with the skin appearing shiny or tight, and clearly defined borders in some cases 1. As the infection progresses, red streaks extending from the infected area may indicate potential spread through lymphatic vessels. Systemic signs such as fever, chills, fatigue, and swollen lymph nodes near the infection site often accompany more severe cases. Blisters, skin dimpling, or areas of skin breakdown may develop in the affected region. Cellulitis commonly affects the lower legs but can occur anywhere on the body. The infection develops when bacteria enter through breaks in the skin, such as cuts, scrapes, or skin conditions like eczema. People with weakened immune systems, diabetes, or circulation problems face higher risks. Some key points to consider in the diagnosis and management of cellulitis include:
- Cultures of blood or cutaneous aspirates, biopsies, or swabs are not routinely recommended, but may be considered in certain patient populations, such as those with malignancy on chemotherapy, neutropenia, severe cell-mediated immunodeficiency, immersion injuries, and animal bites 1.
- Typical cases of cellulitis without systemic signs of infection should receive an antimicrobial agent that is active against streptococci, and the recommended duration of antimicrobial therapy is 5 days, but treatment should be extended if the infection has not improved within this time period 1.
- Elevation of the affected area and treatment of predisposing factors, such as edema or underlying cutaneous disorders, are recommended, and outpatient therapy is recommended for patients who do not have SIRS, altered mental status, or hemodynamic instability 1. It is essential to seek medical attention promptly if signs of cellulitis are noticed, as the infection requires antibiotic treatment to prevent serious complications.
From the Research
Signs of Cellulitis
The signs of cellulitis typically include:
- Erythema (redness of the skin) 2
- Swelling over the affected area 2
- Warmth of the skin 2
- Tenderness over the affected area 2
Common Mimics of Cellulitis
Some dermatologic diseases can present with similar findings to cellulitis, including:
Diagnosis and Treatment
Diagnosis of cellulitis can be confirmed through:
- History of the patient 2
- Local characteristics of the affected area 2
- Systemic signs 2
- Laboratory tests 2
- Skin biopsy in some cases 2 Treatment of cellulitis usually involves oral antibiotics, with dicloxacillin or cephalexin being the oral therapy of choice when methicillin-resistant Staphylococcus aureus is not a concern 2