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Cellulitis (Tutorial)
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Cellulitis is a bacterial infection involving the inner layers of the skin.[1] 100px|left

Tissues affected

It specifically affects the dermis and subcutaneous fat.[1] Signs and symptoms include an area of redness which increases in size over a few days.[1] 100px|left


The borders of the area of redness are generally not sharp and the skin may be swollen.[1] While the redness often turns white when pressure is applied, this is not always the case.[1] 100px|left


The area of infection is usually painful.[1] Lymphatic vessels may occasionally be involved,[1][2] and the person may have a fever and feel tired.[3] 100px|left


The legs and face are the most common sites involved, though cellulitis can occur on any part of the body.[1] 100px|left


The leg is typically affected following a break in the skin.[1] Other risk factors include obesity, leg swelling, and old age.[1] 100px|left


For facial infections, a break in the skin beforehand is not usually the case, and can be tooth related.[1] The bacteria most commonly involved are streptococci and Staphylococcus aureus.[1] 100px|left

Superficial infections

In contrast to cellulitis, erysipelas is a bacterial infection involving the more superficial layers of the skin, present with an area of redness with well-defined edges, and more often is associated with a fever.[1] 100px|left


Diagnosis is usually based on the presenting signs and symptoms, while cell culture is rarely possible.[1] 100px|left

Deeper infections

Before making a diagnosis, more serious infections such as an underlying bone infection or necrotizing fasciitis should be ruled out.[2] 100px|left


Treatment is typically with antibiotics taken by mouth, such as cephalexin, amoxicillin or cloxacillin.[1][4] 100px|left

Penicillin allergy

For those who are seriously allergic to penicillin, erythromycin or clindamycin may be used.[4] When methicillin-resistant S. aureus (MRSA) is a concern, doxycycline or trimethoprim/sulfamethoxazole may, in addition, be recommended.[1] 100px|left

Pus or MRSA

Concern is related to the presence of pus or previous MRSA infections.[1][3] Elevating the infected area may be useful, as may pain killers.[2][4] 100px|left


Potential complications include abscess formation.[1] Around 95% of people are better after seven to ten days of treatment.[3] 100px|left


Those with diabetes, however, often have worse outcomes.[5]


Cellulitis occurred in about 21.2 million people in 2015.[6] In the United States about two of every 1,000 people per year have a case affecting the lower leg.[1] 100px|left


Cellulitis in 2015 resulted in about 16,900 deaths worldwide.[7] In the United Kingdom, cellulitis was the reason for 1.6% of admissions to a hospital.[4] 100px|left


  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 Vary, JC; O'Connor, KM (May 2014). "Common Dermatologic Conditions". Medical Clinics of North America. 98 (3): 445–85. doi:10.1016/j.mcna.2014.01.005. PMID 24758956.
  2. 2.0 2.1 2.2 Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) (7th ed.). New York: McGraw-Hill Companies. p. 1016. ISBN 978-0-07-148480-0.
  3. 3.0 3.1 3.2 Mistry, RD (Oct 2013). "Skin and soft tissue infections". Pediatric Clinics of North America. 60 (5): 1063–82. doi:10.1016/j.pcl.2013.06.011. PMID 24093896.
  4. 4.0 4.1 4.2 4.3 Phoenix, G; Das, S; Joshi, M (Aug 7, 2012). "Diagnosis and management of cellulitis". BMJ. Clinical Research. 345: e4955. doi:10.1136/bmj.e4955. PMID 22872711.
  5. Dryden, M (Sep 2015). "Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections". Clinical Microbiology and Infection. 21: S27–S32. doi:10.1016/j.cmi.2015.03.024. PMID 26198368.
  6. GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  7. GBD 2015 Mortality and Causes of Death, Collaborators (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.