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cellulitis pictures, Definition and Types

Dr.Kut | Jan 06, 2010 | Comments 0

What is Cellulitis?

Cellulitis is a superficial inflammation involving the skin and subcutaneous tissues. They are often characterized by a warm, erythematous, indurated lesion which is more often accompanied by pain. For the distribution of this skin disease, the extremities are the ones commonly involved.

What are the types of Cellulitis?

The types of cellulitis may be classified according to its location. The frequently involved areas are the extremities for which include the hands, forearms, legs, and feet. As the name implies, this type of cellulitis are called cellulitis of the extremities. The other less common types are frequently referred to as facial, nasal, orbital, periorbital, perianal, genital and breast cellulitis. Under the special types of cellulitis, the skin infected along the central face especially the orbits are considered life threatening due to the communicating vessels along this area into the brain via the cavernous sinus. On such cases, intense treatments available must be provided.

What are the causes and risk factors of cellulitis?

The most common etiologic agents of cellulitis are the innate flora colonizing the skin for which includes Staphylococcus aureus and Streptococcus pyogenes. In most sporadic causes, other bacteria are identified such as group B streptococci in the newborn, pneumococci, and gram negative bacilli. As for the immunocompromised individual, some pathogens involved are yeasts and molds. In correlation with conditions of increasing age, prolonged hospitalization, immunocompromised states, diabetes and steroid use; Eschericia coli, Enterobacteriaceae and anaerobes are commonly involved. Following is the list of the causes of cellulitis with its associated condition.

a) Bacterial infection – streptococcus pyogenes, staphylococcus aureus

b) Recurrent bacterial cellulitis of the extremities – Group A, C, or G streptococcus bacteria in association with venous stasis seen on coronary artery bypass surgery patients, chronic lymphedema, and lymph node dissection.

c) Streptococcus agalactiae (Group B streptococci) – elderly individuals with diabetes and peripheral vascular disease

d) Haemophilus influenza – periorbital cellulitis in children

e) Pasteurella multocida – after dog or cat bite

f) Anaerobes – dog and human bites

g) Aeromonas hydrophilia – lacerations sustained in fresh water (lakes, rivers and streams)

h) Vibrio vulnificus – after salt water trauma

i) Pseudomonas aeruginosa – hospitalized and immunocompromised individual

What are the symptoms of cellulitis?

The occurrence of infection causes inflammation, erythema, and localized pain, occasionally accompanied by systemic symptoms to include fever, chills, and malaise. Other associated symptoms may include lymphadenopathy, nausea, vomiting, and confusion, especially in the elderly.

How is the diagnosis of cellulitis made?

The diagnosis of cellulitis is usually made through a physician’s clinical judgment. Careful inspection, thorough physical examination and medical history contribute on the formulation of diagnosis. In medical history, epidemiologic data should be obtained so as to provide better etiologic assessment since many diversified exogenous bacteria can cause cellulitis as well.

In most cases, visual inspection of the affected skin demonstrates a red, warm, inflamed, and painful lesion. A physician will search for cracks in the skin for which serves as a portal of entry for numerous pathogens.

Other medical conditions may pose similar symptoms with cellulitis so they are fully recognized before making a diagnosis. Such medical conditions consist of the following:

a) Peripheral vascular disease – Deep vein thrombosis

b) Gout

c) Contact dermatitis

d) Insect stings

e) Lymphomas

f) Leukemia

g) Sarcoidosis

h) Radiation therapy

In most cases of recurrent and chronic conditions, swab or blood cultures are utilized to identify the causative microbe causing the symptoms of cellulitis. When severe infection or clot is suspected, the Doppler ultrasound is used. As for the case of orbital cellulitis, Computed Tomography scan or Magnetic Resonance Imaging of the sinuses and orbit tissues are performed to help determine the location of cellulitis as well as to assess deeper structure involvement such as tumor swelling.

What is the treatment for cellulitis?

For the treatment of infection, antibiotics are essentially used to specifically combat the microorganisms causing symptoms. The duration of treatment for oral antibiotics is 10-14 days while intravenous treatments are used only for shorter period of 3-5 days. Parenteral route of antibiotics is usually done for severe or systemic spread of infection. Antibiotics used for treatment of cellulitis are Cephalexin, Ceftriaxone, Dicloxacillin, and Clindamycin. For patients with debilitating medical problems such as diabetes, a broader coverage of antibiotics is used to fight gram negative rods as well.

In order to alleviate pain and provide comfort, pain reliever drugs, and warm soaks on affected area can also implemented. Wound care is performed in order to prevent recurrent infection of cellulitis. Open breaks or cuts on skin must be covered and kept dry. Proper skin and nail hygiene is often the most effective way for prevention.

Cellulitis pictures: