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Cellulitis

DEFINITION

Cellulitis is the medical term for bacterial infection of the skin. This infection causes redness, heat and pain in the affected area. Cellulitis may appear after an injury that you remember or may seem to appear out of nowhere. If left alone, cellulitis can progress into a serious infection even spreading to the bloodstream. While cellulitis can appear anywhere on the body, it is most common on the legs. The two most common bacteria causing cellulitis are staphylococcus and streptococcus. These bacteria normally live on the surface of our skin but do not cause a problem unless then get below the top layer of skin. Bacteria are most likely to enter through a break in the surface of the skin like a cut or puncture, but can enter where you have cracked skin from things like athlete’s foot as well. Risk factors for getting cellulitis include having a known break in the skin, having a weakened immune system (as with HIV or diabetes), having skin conditions like eczema or athlete’s foot that lead to flaky or broken skin, swelling of the arms or legs (lymphedema), and use of intravenous drugs (a needle below the skin allows bacteria to enter). Infection from cellulitis can spread to deeper layers of tissue including the fascia, muscle, bone, and even the bloodstream. If the infection is with certain bacteria, so-called flesh-eating bacteria or necrotizing fasciitis, the infection can spread extremely rapidly and be very dangerous. An abscess or pocket of infection can also develop below the affected skin. You should seek prompt medical attention for any infection of the skin.

SYMPTOMS
Redness of skin, pain of skin, swelling of skin, warmth of skin, fever

DIAGNOSIS
Your doctor will begin by talking to you about your symptoms and doing a physical exam focused on the area of your symptoms. Your doctor will want to know about any injuries to the area. Your doctor may want to check blood tests to see if your white blood cell count is elevated (which happens in infections) or if you have bacteria in your blood.

TREATMENT
Treatment of cellulitis depends on the severity of your infection. If your infection is not severe, your doctor will prescribe antibiotics by mouth for a week or longer. You must be sure to take all of the antibiotics because the symptoms may go away before the infection is fully treated. Your doctor may want to see you back to see if your infection is improving. If you have an abscess below the skin, your doctor may want to drain the abscess by making a small incision to get the pus out. If the bacteria has entered the blood stream, you will likely need to be hospitalized for antibiotics through the vein (intravenous). If you have a rapidly spreading infection like necrotizing fasciitis, the only treatment that will help is fast removal of the affected skin in the operating room. Necrotizing fasciitis is an emergency. In order to prevent cellulitis, you should wash any skin wound with soap and water daily as well as using an antibiotic cream like polymycin or bacitracin. You should monitor the wound for any redness or swelling as these may be the first signs of infection. If you have diabetes or other conditions making you more prone to injuries of the feet like poor circulation, you should wear protective footwear even in the house and check your feet for injuries daily and use care when cutting your nails. If you need specialized care for your wound, your doctor may recommend going to a wound care clinic where you can be taught to care for your wound. You should discuss your treatment options with your doctor.

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