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Cellulitis: Causes, Symptoms and Treatment

Cellulitis is a bacterial skin infection affecting the deeper layers of the skin and underlying tissue. It causes redness, swelling, and pain and requires prompt medical treatment.

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Things worth knowing about "Cellulitis"

Cellulitis is a bacterial skin infection affecting the deeper layers of the skin and underlying tissue. It causes redness, swelling, and pain and requires prompt medical treatment.

What is Cellulitis?

Cellulitis is an acute bacterial infection of the deeper layers of the skin, including the dermis and subcutaneous tissue. It should not be confused with cosmetic cellulite (dimpled skin). Although cellulitis can occur anywhere on the body, it most commonly affects the lower legs and face.

Causes

Cellulitis is typically caused by bacteria that enter the skin through cuts, cracks, insect bites, or other skin injuries. The most common causative organisms are:

Streptococcus pyogenes (Group A Streptococcus)
Staphylococcus aureus, including MRSA (methicillin-resistant Staphylococcus aureus)

Risk factors include diabetes mellitus, a weakened immune system, chronic oedema, obesity, and a previous history of cellulitis.

Symptoms

Common signs and symptoms of cellulitis include:

Redness and warmth in the affected area
Swelling and a feeling of tightness
Pain or tenderness to the touch
Fever and general feelings of illness in more severe cases
Possible development of blisters or abscess formation

Diagnosis

Diagnosis is primarily clinical, based on the characteristic appearance of the skin. Additional investigations may include:

Blood tests to detect elevated inflammatory markers such as CRP and white blood cell count
Wound swabs or blood cultures to identify the causative organism in severe cases
Imaging techniques such as ultrasound or MRI to rule out abscess formation or necrotising fasciitis

Treatment

Antibiotic Therapy

The primary treatment for cellulitis is antibiotics. Mild cases are typically treated with oral antibiotics such as penicillin, amoxicillin-clavulanate, or cephalosporins. Severe or rapidly worsening infections may require hospitalisation and intravenous antibiotics.

Supportive Measures

Elevating the affected limb to help reduce swelling
Pain relief medications such as ibuprofen or paracetamol
Regular medical follow-up to monitor healing progress

When to Seek Immediate Medical Attention

If the redness spreads rapidly, fever is high, pain becomes severe, or numbness develops, seek emergency medical care immediately. These may be signs of necrotising fasciitis, a life-threatening complication.

Prevention

Preventive measures include thoroughly cleaning and covering wounds, moisturising dry or cracked skin, treating fungal infections such as athlete's foot promptly, and attending regular medical check-ups when known risk factors are present.

References

Stevens DL et al. - Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 59(2), e10-e52 (2014).
Eron LJ et al. - Managing skin and soft tissue infections: expert panel recommendations on key decision points. Journal of Antimicrobial Chemotherapy, 52 (Suppl 1), S3-S17 (2003).
World Health Organization (WHO) - Antimicrobial Resistance: Global Report on Surveillance (2014).

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