Cellulitis and Erysipelas
Cellulitis
Cellulitis is a common infection of the skin and underlying tissue. Symptoms include warmth, swelling, redness and tenderness. Although cellulitis occurs most commonly in the limbs, it can occur in any part of the body. Patients who have leg ulcers (eg, from diabetes), other wounds or athlete's foot may be more likely to develop cellulitis infections. You are also at a higher risk of developing cellulitis if you have weak or worn veins in your legs.
Cellulitis infections begin when bacteria enter cracks in the skin (through scrapes, cuts, burns, insect bites, surgical incisions, or intravenous needles).
Symptoms
Symptoms in the infected area
- Swelling
- Redness
- Warmth to the touch
- Tenderness
- Enlarged lymph nodes in the affected area
- Infection in lymph nodes
- Pus
- In patients with cellulitis in the lower part of their body, presence of athlete's foot or psoriasis
Bodily symptoms
- Fever
- Chills
- Muscle aches
Not all patients with cellulitis have all the symptoms.
Diagnosis
Doctors usually diagnose cellulitis just by looking at the infection. They may do a bacterial culture (to determine the type of bacteria causing the infection) if the patient is experiencing fever, chills or muscle aches or their treatment is not working. They may also do a culture if the patient has had a previous cellulitis infection or if the doctor believes the infection is caused by contact with an animal or through water.
Cellulitis in certain areas, such as the face, may signify a dental or sinus infection. Cellulitis occurring near a joint may signify an infection in the joints or a bone infection caused by bacteria.
Treatment
Doctors decide how to treat a cellulitis infection based on the bacteria that caused the infection. Cellulitis is treated with either oral or intravenous antibiotics. Some of the antibiotics commonly used are penicillin, clindamycin, trimethoprim-sulfamethoxazole, cephalexin, clarithromycin and azithromycin, and vancomycin.
Erysipelas
Erysipelas is a unique form of superficial cellulitis associated with a marked swelling of the skin that does not involve subcutaneous tissue. Although infants and the elderly are at particular risk, it can affect people at any age. People with skin ulcers, eczematous lesions, chronic fungal infections, local trauma, and venous or lymphatic compromise may be predisposed to erysipelas infections. Patients may experience recurring, persistent erysipelas infections. It is typically caused by group A streptococci and, much less commonly, S aureus, Streptococcus pneumoniae, enterococci and a variety of gram-negative bacilli.
Symptoms
Symptoms in the infected area
- Skin sore with a raised edge
- Pain
- Swelling
- Redness
- Hardened appearance
Bodily symptoms
- High fever
- Prolonged muscle stiffness
- Confusion or mental status changes, particularly in elderly patients
Diagnosis
Because of its unique appearance, erysipelas is typically diagnosed by sight alone.
Treatment
Erysipelas is usually treated with oral antibiotics.
