9 Facts About Cellulitis

Do you know what cellulitis is? If not, this article is your go-to for all the information on cellulitis, and then some.

What is Cellulitis?

Cellulitis is a skin infection caused by bacteria. It affects the skin on different parts of the body such as the arms and legs most commonly, but also the around the anus, eyes, and mouth. It can spread very rapidly and become a serious health issue if not addressed immediately.

Symptoms of Cellulitis

The main symptom is redness, inflammation, and tenderness of the skin, combined with heat/warmth, rashes, pus-filled blisters/bumps, and/or open sores with yellow liquid. There may also be swollen lymph nodes or red streaks from the infection site which usually begins as a small red patch the size of a coin, and expands to larger parts of the limb.

Other accompanying symptoms may include fever, chills/sweating, nausea, and/or vomiting. You may also experience fatigue, low blood pressure, taut and stretched skin, joint pain/stiffness, or muscle aches due to swollen tissue encumbering on the joints.

Causes of Cellulitis

Cellulitis is a bacterial skin infection, which is most likely caused by one of two types of bacteria − Streptococcus A or Staphylococcus. Strep A usually causes a superficial form of cellulitis in children called erysipelas. Other beta-hemolytic streptococci bacteria of Groups B, C, D, E, and F can also cause cellulitis.

Strep and Staph are usually always present on the skin surface and in nasal mucous membranes as benign bacteria. They only become harmful if there is broken skin such as wounds, bites, cracks, or injuries like cuts or burns when they enter deeper layers of the skin and spread the infection.

Cases of methicillin-resistant Staphylococcus aureus (MRSA), are rising, increasing the risk associated with such infections. Since such Staph bacteria are resistant to conventional antibiotic treatments, the medical fraternity is racing to develop newer medicines to overcome this community-acquired development.

Other possible sources of bacterial infection include Pasteurella multocida from dog/ cat bites that require less than 24 hours of incubation time and Pseudomonas aeruginosa from puncture wounds like from glass or nails.

Vibrio vulnificus and Aeromonas hydrophilia bacteria can enter wounds when swimming in water bodies - seawater and freshwater respectively. Hemophilus influenzae i.e., H. flu can infect children 6 years or below in areas in the upper torso and limbs.

Risk Factors for Cellulitis

Apart from cracks, sores, or breaks in the skin from external sources, these factors raise the risk of contracting cellulitis −

• Diabetic ulcers or circulatory diseases like peripheral vascular disease that restrict blood flow to or prevent proper drainage of the lymph nodes in the affected area.

• Skin peeling between fingers/toes

• Surgical wounds that haven’t healed fully

• Use of immunosuppressants, steroids/corticosteroids

• Skin disorders like eczema, tinea pedis/athlete’s foot, or psoriasis

• People with weak immune systems such as those with HIV/AIDS and diabetes are at greater risk

• Drug use via injections or getting tattoos increases your risk of getting cellulitis. Make sure you keep your tattoo clean and sanitized before and after the procedure and get it from a hygienic parlor.

Diagnosis of Cellulitis

Diagnosis usually involves a simple physical examination/observation by the doctor, after taking your medical history, since no diagnostic tests exist for this condition. But the doctor may also take a blood test of full CBC (complete blood count) workup to check what bacteria variant is causing the cellulitis, so treatment can be more specific.

Most times though there is not enough bacteria concentration to give a positive identification through culture. An ultrasound may be given to rule out blood clots in the leg, and skin biopsies might also be done to rule out other skin diseases like folliculitis or impetigo.

Treatment of Cellulitis

Cellulitis can be easily treated with oral, intravenous (IV), or intramuscular antibiotics, the latter two options being reserved for more serious infections. Affected arms and legs i.e., limbs should be kept elevated.

With a period of rest and healing, along with some pain medication, the infection should get better in a few days. Keep the areas clean and sanitized with a washcloth dipped in cool water. You may need surgery if you need to drain pus-filled abscesses.

Complications of Cellulitis

Early detection means easier treatment. However, if the infection isn’t addressed on time, many complications could arise. These infections can spread to the blood (bacteremia), the bones (osteomyelitis), and joints i.e., suppurative arthritis. Blood infections can spread to all the organs in the body causing sepsis, multiple organ failure, and death. Cellulitis can spread further into the skin as necrotizing fasciitis, a “flesh-eating” disease, which causes tissue death, and possible loss of limb and life.

Gangrene or tissue death may also cause a shock to the system and possible amputation. Cellulitis can also cause swelling in the heart's chamber linings i.e., endocarditis, periorbital cellulitis in children which causes eyelid swelling, or even orbital cellulitis which affects the eye socket and can lead to blindness if not treated quickly.

Repeat Incidence

If you have had a history of cellulitis before, you are at higher risk of getting it again. You’ll need to take extra precautions not to pierce your skin or hurt yourself, use insect repellents and stay away from stray animals.

If you do get injured, keep the wound clean using warm water and soap and bandage it to protect it and allow healing, in addition to completing your dosage of antibiotics. If you have more than 3-4 recurrences a year, you may need to start low-dose antibiotics for a longer period.

Cellulitis does not equal Cellulite

The similarity between the two terms is befuddling! Cellulite refers to deposits of fat that cause dimpling of skin usually on the thighs, buttocks, and waist. It is a cosmetic alteration that can be addressed with exercise, weight loss, and retinol creams amongst others whereas cellulitis is a bacterial infection.

Conclusion

Seeing as how cellulitis affects upwards of 14 million people a year, stay informed and vigilant to remain safe and healthy!