Filed under: Boomer's Health
Cellulitis (sel-u-LI-tis) is a common, potentially serious bacterial
skin infection. Cellulitis appears as a swollen, red area of skin that
feels hot and tender, and it may spread rapidly.
Skin on lower legs is most commonly affected, though cellulitis can
occur anywhere on your body or face. Cellulitis may affect only your
skin's surface — or, cellulitis may also affect tissues underlying your
skin and can spread to your lymph nodes and bloodstream.
Left untreated, the spreading infection may rapidly turn
life-threatening. That's why it's important to seek immediate medical
attention if cellulitis symptoms occur.
Possible signs and symptoms of cellulitis include:
The changes in your skin may be accompanied by a fever. Over time, the
area of redness tends to expand. Small red spots may appear on top of
the reddened skin, and less commonly, small blisters may form and burst.
When to see a doctor
If you have a rash that's red, swollen, tender and warm — and it's
expanding — try to see your doctor the same day. If a fever or pain
accompanies the rash, or the rash is changing rapidly, seek emergency
care. It's important to identify and treat cellulitis early because the
condition can cause a serious infection by spreading rapidly throughout
Cellulitis occurs when one or more types of bacteria enter through a
crack or break in your skin. The two most common types of bacteria that
are causes of cellulitis are streptococcus and staphylococcus. 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. Disrupted areas of skin, such as where you've
had recent surgery, cuts, puncture wounds, an ulcer, athlete's foot or
dermatitis, serve as the most likely areas for bacteria to enter.
Certain types of insect or spider bites also can transmit the bacteria
that start the infection. Areas of dry, flaky skin also can be an entry
point for bacteria, as can swollen skin.
Several factors can place you at greater risk of developing cellulitis:
* Known injury. Any cut, fracture, burn or even a scrape increases
your risk of cellulitis because the injury gives bacteria an entry
* Weakened immune system. Conditions that weaken your immune system
leave you more susceptible to infections such as cellulitis. Possible
conditions that can weaken your immune system include diabetes, chronic
leukemias, HIV/AIDS, chronic kidney disease, liver disease, circulation
disorders and the use of certain medications, such as corticosteroids.
* Skin conditions. Certain skin disorders, such as eczema, athlete's
foot, chickenpox and shingles, cause breaks in the skin and increase
your risk of cellulitis.
* Chronic swelling of your arms or legs (lymphedema). Swollen tissue
may crack, leaving your skin vulnerable to bacterial infection.
* Intravenous drug use. People who inject illicit drugs have a higher risk of developing cellulitis.
This reddened skin or rash may signal a deeper, more serious infection
of the inner layers of skin. Once below your skin, the bacteria can
spread rapidly, entering your lymph nodes and your bloodstream and
spreading throughout your body. Recurrent episodes of cellulitis may
actually damage the lymphatic drainage system and cause chronic swelling
of the affected extremity.
In rare cases, the infection can spread to the deep layer of tissue
called the fascial lining. Flesh-eating strep, also called necrotizing
fasciitis, is an example of a deep-layer infection. It represents an
Preparing for your appointment
You're likely to start by first seeing your family doctor or a general
practitioner. However, you may then be referred to a doctor who
specializes in skin disorders (dermatologist), or if you have a severe
infection, you may first be seen by an emergency room doctor. You may
also be seen by an infectious disease specialist.
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
* Write down any symptoms you're experiencing, including any that
may seem unrelated to the reason for which you scheduled the
* Write down key personal information, such as if you've had any
recent surgeries, injuries, animal bites or even insect bites. However,
you may not always be aware of a small break in your skin.
* Make a list of all medications, as well as any vitamins or supplements, that you're taking, along with the dosage.
* Write down questions to ask your doctor.
Preparing a list of questions can help you make sure that you cover the
points that are important to you. For cellulitis, some basic questions
to ask your doctor include:
* How might I have gotten this infection?
* What kinds of tests do I need? Do these tests require any special preparation?
* How is this treated?
* How long before the treatment starts working?
* What kinds of side effects are possible with this medication?
* Are there any alternatives to antibiotics?
* Is there a generic alternative to the medicine you're prescribing me?
* How can I prevent this type of infection in the future?
* Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
In addition to the questions that you've prepared to ask your doctor,
don't hesitate to ask questions during your appointment any time you
don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to
answer them may reserve time to go over any points you want to spend
more time on. Your doctor may ask:
* When did you first begin experiencing symptoms?
* Do you remember any injuries to that area? Or insect bites?
* How severe is the pain?
* Does anything seem to improve your symptoms?
* Are you allergic or intolerant of any antibiotics?
* Have you had this type of infection before?
What you can do in the meantime
You may need a prescription antibiotic to clear your infection. However,
while you're waiting for your doctor's appointment, you can wash the
injured area with soap and water and then apply an over-the-counter
antibiotic cream or ointment.
Tests and diagnosis
The appearance of your skin will help your doctor make a diagnosis. Your
doctor may also suggest blood tests, a wound culture or other tests to
help rule out a blood clot deep in the veins of your legs. Cellulitis in
the lower leg is characterized by signs and symptoms that may be
similar to those of a clot occurring deep in the veins, such as warmth,
pain and swelling.
Treatments and drugs
Cellulitis treatment may involve a prescription oral antibiotic. You'll
likely recheck with your doctor one to three days after starting an
antibiotic to ensure that the infection is responding to treatment.
You'll need to take the antibiotic for up to 14 days. In most cases,
signs and symptoms of cellulitis disappear after a few days. If they
don't clear up, if they're extensive or if you have a high fever, you
may need to be hospitalized and receive antibiotics through your veins
Usually, doctors prescribe a drug that's effective against both
streptococci and staphylococci. Your doctor will choose an antibiotic
based on your circumstances.
No matter what type of antibiotic your doctor prescribes, it's important
that you take the medication as directed and that you finish the entire
course of medication, even if you start feeling better.
To help prevent cellulitis and other infections, follow these measures anytime you have a skin wound:
* Wash your wound daily with soap and water. Do this gently as part of your normal bathing.
* Apply an antibiotic cream or ointment. For most surface wounds, a
single- or double-antibiotic ointment provides adequate protection.
* Watch for signs of infection. Redness, pain and drainage all
signal possible infection and the need for medical evaluation.
People with diabetes and those with poor circulation need to take extra
precautions to prevent skin wounds and treat any cuts or cracks in the
skin promptly. Good skin-care measures include the following:
* Inspect your feet daily. Regularly check your feet for signs of injury so you can catch any infections early.
* Moisturize your skin regularly. Lubricating your skin helps prevent cracking and peeling.
* Trim your fingernails and toenails carefully. Take care not to injure the surrounding skin.
* Protect your hands and feet. Wear appropriate footwear and gloves.
* Promptly treat any superficial skin infections, such as athlete's
foot. Infections on the surface of the skin (superficial) can easily
spread from person to person. Don't wait to start treatment.