Cellulitis

Cellulitis is a term used to describe inflammation of the skin and the tissues below the skin. It is caused by an acute infection, and commonly due to bacteria. This is often when there is a break into the skin which forms a portal of entry for infection. It commonly affects the arms and legs, however, can also develop around the eyes, belly, mouth and anus.

The risk factors for developing cellulitis include having an injury or trauma with a break in the skin, insect and animal bites, ulcers from diabetes and vascular disease. Individuals with weakened immune systems are also prone to developing cellulitis. A recent history of surgery also is a risk factor.

The cardinal symptoms of cellulitis are redness, severe pain, warmth and swelling of the affected area. Other symptoms may include fever, headache, chills, weakness of the affected limb, red streaks from the site of cellulitis and formation of blisters. They are clinical features that can suggest that urgent care is needed with this condition. These include having a large area of red, inflamed skin or if the skin now changes colour and becomes black, showing that there are some dead tissues. People with swelling around the eyes or behind the ears should also seek help immediately as it can lead to dire consequences when the infection spreads to surrounding structures. Numbness or tingling of the affected arm or leg is also a bad sign and requires urgent medical review. It is also advisable for diabetics to seek help as soon as possible as they have weak immune systems and poor wound healing. If they present late it can lead to spread of infection and eventually amputation of the affected limb.

The diagnosis of this condition is often straightforward and does not need a lot of investigations. Diagnosis is based on an appropriate history and compatible physical examination findings. Investigations such as blood work can be done to exclude severe infection that has now spread to the rest of the body. In cases of severe limb swelling, an ultrasound scan is done to exclude blood clots in the deep blood vessels.

Mild to moderate cellulitis can be treated successfully with oral antibiotics. Cases that are severe often require inpatient admission and provision of intravenous (through a drip) medication. In some cases, surgical drainage of abscesses as well as removal of dead tissues may be required.

Cellulitis is not an uncommon condition and can have bad consequences of loss of limb or life if not detected early. It is important for those with the cardinal features of cellulitis to seek medical help to treat it appropriately.