Introduction
Cellulitis is a common bacterial skin infection.
Affected skin may appear swollen, painful, and warm to the touch (Santos et al., 2018).
It mainly affects the lower legs, face and arms.
Hesitation to treat the disease can affect lymph nodes and the bloodstream, becoming life-threatening.
Causes
Bacterial infection.
The bacteria enter through openings and skin cracks.
Affects the deep layers of the skin.
Streptococcus and staphylococcus infections are most common (Webb et al., 2020).
Signs & Symptoms
Erythema
Edema
Pain in the affected area.
Warmth
Fever
Blisters
Skin dimpling (Sullivan & Barra 2018).
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Pathophysiology
Bacteria invades open skin.
It overwhelms neutrophils, eosinophils, and basophils, causing inflammation over 1st 72 hrs. (Sullivan & Barra 2018).
As infection progress it invades healthier cells.
Blisters formulate in the affected area.
Differential Diagnosis
Lymphatic filariasis- the disease is caused by microscopic parasites, and thread-like worms.
Chronic venous insufficiency- occurs when your lower legs veins fail to deliver back blood to the heart (Webb et al., 2020).
Acute deep venous thrombosis – blood clots in one or more deep veins.
Lipedema – excessive fat remains and accumulates in the victim.
Diagnosis
– Skin examination
CBC
Gram stain and culture of fluid from abscess and bulla (Sullivan & Barra 2018).
Culture of the primary lesion by aspiration.
Blood cultures often negative (only 10% positive)
Wound cultures often negative (70%)
Purulence = often S. Aureus.
Animal bites = often gram-negative bacteria.
Risk Factors
Weakened immune system
Lymphedema
History of cellulitis
Obesity
Skin conditions
Injury
Treatment
Outpatient: Oral antibiotics.
Amoxicillin is commonly used due to its bioavailability
250-500 mg PO 3 x daily (Webb et al., 2020).
Usually 5 to 10 days, depending on severity.
Follow up in 3 days regarding progress
No improvement or new fever = ER visit.
Teaching
Keep the infected area clean.
Record temperature daily for a week.
Maintain hygiene to avoid infection spread (Webb et al., 2020).
Take entire abx supply until gone to avoid reinfection.
OTC drugs to use for pain
Acetaminophen
325-1000 mg PO q 8 hrs
Ibuprofen
200-600 mg PO q 8 hrs
