A common infection
Cellulitis (sel-u-LIE-tis) is a common infection of the skin and the soft tissues underneath. It happens when bacteria enters a break in the skin and spreads. The result is an infection, which may cause swelling, redness, pain, or warmth to the area. Cellulitis usually affects the skin on the lower legs, but it can occur anywhere on the body, the face, arms or other areas. It occurs when a crack or break in your skin allows bacteria to enter. Left untreated, the infection can spread to your lymph nodes and bloodstream, rapidly becoming life-threatening. It does not usually spread from person to person.
Cellulitis usually occurs on one side of the body. Possible signs and symptoms of cellulitis include:
• Red area of skin that tends to expand, swelling, tenderness, pain, warmth, or fever
• Red spots, blisters, skin dimpling
Cellulitis occurs when bacteria, most commonly gram-positive bacteria like streptococcus and staphylococcus, enter through a crack or break in your skin. The incidence of a more serious staphylococcus infection called methicillin-resistant staphylococcus aureus (MRSA) is increasing.
Although cellulitis can occur anywhere on your body, the most common location is the lower leg. Bacteria are most likely to enter disrupted areas of skin, such as where you’ve had recent surgery, cuts, scratches or puncture wounds, an ulcer, athlete’s foot or dermatitis. Animal bites can cause cellulitis. Bacteria can also enter through dry, flaky skin or swollen skin.
Several factors put you at increased risk of cellulitis:
Injury: Any cut, fracture, burn or scrape gives bacteria an entry point.
Weakened immune system: Conditions that weaken your immune system — such as diabetes, leukemia and HIV/AIDS — leave you more susceptible to infections. Certain medications also can weaken your immune system.
Skin conditions: Conditions such as eczema, athlete’s foot and shingles can cause breaks in the skin, which gives bacteria an entry point.
Chronic swelling of your arms or legs (lymphedema): This condition sometimes follows surgery.
History of cellulitis: Having had cellulitis before makes you prone to develop it again.
Obesity: Being overweight or obese increases your risk of developing cellulitis.
When to see a doctor
It’s important to identify and treat cellulitis early because it can spread quickly throughout your body. If you think you have cellulitis seek medical care if:
• You have a red, swollen, tender, warm rash
• With or without a fever or chills
• Nausea and vomiting
• Enlarging or hardening of the reddened area
• Increased pain
• Numbness of the area when touched
Exams and tests
At the doctor’s visit, your doctor will take a medical history and do a physical exam. They may also order a blood test if the infection is suspected to have spread to your blood stream. An x-ray or a culture may also be done to rule out foreign objects.
• Rest the area
• Elevate the area to help reduce swelling and relieve pain
• Use over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin) to ease the pain, as well as keep your fever down.
If the infection isn’t too bad, antibiotics by mouth for a week to 14 days will be ordered. If the infection is severe, IV antibiotics will be ordered and sometimes you may need to stay in the hospital for a while. A follow-up appointment will be scheduled to make sure the infection is gone.
Recurrent episodes of cellulitis may damage the lymphatic drainage system and cause chronic swelling of the affected limb. The infection can spread to the deep layers of the skin but this rarely happens. When this occurs, necrotizing fasciitis is an example of a deep-layer infection. It is an emergency.
If cellulitis recurs, your doctor may recommend antibiotics to help prevent cellulitis and other infections. If you have an open wound or cut, take these precautions to make sure it heals and does not get infected.
Cleanse wound daily: Soak gauze or cotton in saline and gently wipe the area.
Apply a protective cream or ointment: For most superficial wounds, use an over-the-counter ointment or hydrogel to provide a moist wound environment.
Cover your wound with a bandage: Change bandages at least once daily.
Watch for any signs of infection: Redness, pain and drainage all signal possible infection and the need for a medical evaluation.
People with diabetes and those with poor circulation need to take extra precautions to prevent skin injury. Good skin care measures include the following:
Inspect your feet daily: Regularly check your feet for signs of injury so you can catch infections early.
Moisturize your skin regularly: Lubricating your skin helps prevent cracking and peeling. Do not apply moisturizer to open sores.
Trim your fingernails and toenails carefully: Take care not to injure the surrounding skin.
Protect your hands and feet: Wear appropriate footwear and gloves.
Treat infections on the skin (superficial), such as athlete’s foot quickly: Superficial skin infections can easily spread from person to person. Don’t wait to start treatment.
• For more information or to see a podiatrist, visit Bahamas Foot Centre Rosetta Street, telephone 325-2996; or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820; or email firstname.lastname@example.org; or visit www.apma.org.