Video:Cellulitis
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Definition
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
Symptoms
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
Pain
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
Cause
The legs and face are the most common sites involved, though cellulitis can occur on any part of the body.[1] 100px|left
Legs
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
Face
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
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
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
Complications
Potential complications include abscess formation.[1] Around 95% of people are better after seven to ten days of treatment.[3] 100px|left
Diabetes
Those with diabetes, however, often have worse outcomes.[5]
Epidemiology
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
Mortality
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
References
- ↑ 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.
- ↑ 2.0 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.
- ↑ 3.0 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.
- ↑ 4.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.