Cellulitis (cel·u·li·tis) means “inflammation of the cells”. It is a common and serious bacterial infection of the lower layers of skin (dermis) and underlying tissues (the subcutaneous tissues) that can affect any area of the body. Cellulitis appears as a swollen, red area of skin that feels hot and tender, and it may spread rapidly. In other words, Cellulitis is a diffuse inflammatory process within solid tissues, which does not block blood vessels and occurs in the loose tissues beneath the skin or beneath mucous membranes or around muscle bundles or surrounding organs.
It often begins in an area of broken skin, like a cut or scratch. Staphylococcus aureus and Group A streptococcus bacteria are the most common causes of Cellulitis, though other types of bacteria may cause the condition. They invade and spread through lymph nodes and bloodstream causing inflammation, pain, swelling, warmth, and redness. Skin on the face or lower legs is most commonly affected by this infection, though Cellulitis can occur on any part of the body.
Normal skin has many types of bacteria living on it. When there is a break in the skin, these bacteria can cause a skin infection. Majority of cellulitis infections are caused by bacteria streptococcus and staphylococcus and the most common bacteria that cause cellulitis are beta-hemolytic streptococci (groups A, B, C, G, and F). Risk factors include chickenpox, scratched insect bites, animal bites, puncture wounds, cracks or peeling skin between the toes, recent surgery, an ulcer, athlete’s foot, dermatitis, fracture, burn or even a scrape. Other factors are history of peripheral vascular disease, conditions that weaken the immune system (diabetes, chronic leukemias, HIV/AIDS, chronic kidney disease, liver disease and circulation disorders), a previous history of Cellulitis, being overweight and use of corticosteroid medications.
Special types of Cellulitis are sometimes designated by the location of the infection. Examples include periorbital (around the eye socket) Cellulitis, Buccal (cheek) Cellulitis, facial cellulitis, and perianal cellulitis. A form of rather superficial cellulitis caused by strep (Streptococcus) is called erysipelas and is characterized by spreading hot, bright red circumscribed area on the skin with a sharp, raised border. The incidence of a more serious staphylococcus infection called methicillin-resistant Staphylococcus aureus (MRSA) is increasing, as it is resistant to many antibiotics it is more difficult to treat.
Cellulitis usually begins as a small, inflamed area of pain, swelling, warmth, and redness on the skin. As this red area begins to spread, the patient may begin to feel sick and develop a fever, sometimes with chills and sweats. Swollen lymph nodes (commonly called swollen glands) are sometimes found near the area of infected skin. It may occur anywhere on the body, but the lower leg is the most common site of the infection (particularly in the area of the tibia or shinbone and in the foot). However arm, neck, and the head area are also common.
Skin sore or rash that starts suddenly, and grows quickly in the first 24 hours, tight, glossy, “stretched” appearance of the skin are also some of the symptoms of Cellulitis. Other symptoms that can occur with this disease are hair loss at the site of infection, Joint stiffness caused by swelling of the tissue over the joint, fatigue, nausea and vomiting.
The doctor will perform a physical examination which must reveal:
- Redness, warmth, and swelling of the skin
- Possible drainage, if there is an infection
- Swollen gland (lymph nodes) near the affected area
Blood tests (blood culture and blood count), a wound culture or other tests can also be suggested.
Very rarely in very mild cases or when there is a chance of a misdiagnosis the doctor just observes the reddened area for a few days and then follows it up with appropriate treatment. In many cases of Cellulitis, the concentration of bacteria may be low and cultures fail to demonstrate the causative organism. If the diagnosis is not done properly it may lead to complications like blood infection (sepsis, osteomyelitis), Inflammation of the heart (endocarditis), Inflammation of the lymph vessels (lymphangitis), Tissue death (gangrene), etc.
Main purpose of Cellulitis treatment process is reduction of severity infection, fast recovery, pain relief, cure affected skin and prevention of recurrence. Cellulitis is commonly treated with antibiotics therapy that is designed to eradicate the most likely bacteria to cause the particular form of Cellulitis. A child with severe Cellulitis may be treated in the hospital using intravenous (IV) antibiotics. The antibiotics given may vary depending on the type of bacteria that are causing the infection, the severity of the infection and any drug sensitivities that the patient may have. Antibiotics, such as derivatives of penicillin or other types of antibiotics that are effective against the responsible bacteria, are used to treat Cellulitis.
In case of mild infection self-care home treatment like drinking plenty of water, elevating the region of the body affected with Cellulitis, taking pain killers and resting the body help ease symptoms and speed up recovery. It can be further prevented by proper hygiene, treating chronic swelling of tissues (edema), care of wounds or cuts.
Cellulitis usually goes away with 7 – 10 days of antibiotics, but very severe cases or rapidly deteriorating conditions, hospitalization may be necessary.
There is a higher chances of a reoccurrence of the infection but Cellulitis is not contagious because it is an infection of the skin’s deeper layers (the dermis and subcutaneous tissue), and the skin’s top layer (the epidermis) provides a cover over the infection.