Cellulitis is a bacterial skin infection. Signs are acute redness of the skin, and oedema with rough borders. It usually affects lower limbs but any skin region can become infected.
The causes of cellulitis in when the skin barrier is damaged such that bacteria can cross over the skin layers and infect cells. People with pre-existent conditions such as diabetes, obesity, bite wounds or insufficient pump function of the veins are susceptible to cellulitis. Bacteria called stapylococcus aureus is the cause in 80% of cases.
The GP will differentiate between cellulitis and erysipelas. The latter is more superficial and has well marked edges or borders and usually is elevated. The GP will want to know
- How long the region of the skin has been affected
- what happened prior to developing symptoms
- Recurrence of symptoms
- Recovering from skin disease
- Presence of fever or general unwell
- If the redness spread out
- if there is pain or hypersensitivity
- Pre-existent conditions as mentioned above
A GP will check physically for the size, thickness of the cellulitis. Also comparing the skin temperature difference beween the affected skin are and normal area can be performed. Palpating for lymph nodes is an important part of the physical examination. Blood tests may be requested by the GP if cellulitis is associated with fever, chills, general unwell appearance, lymph nodes oedema or cellulitis located near the mouth or eye.
Management of cellulitis consists of
- Hygiene; keep the area clean and dry
- Pain relief; cellulitis can be very painful. Take Paracetamol 500mg, 2 tablets 4 times a day
- Bandage, elevate and immobilise the limb
- Oral antibiotics in those with no pre-existent conditions
- Flucloxacilline 500mg one tablet four times a day for 10 days
- Oral antibiotics in those with pre-existent conditions
- Amoxicilline/Clavulanic acid 625mg, one tablet 3 times a day for 7 to 10 days
- Doxycycline 200 mg one tablet once a day for 7 to 10 days