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cellulitis

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Cellulitis

Definition
Cellulitis is an infection of the skin and the layer under the skin.

What is going on in the body? 
Although the legs are the most common site, this condition can develop on any skin of the body. It tends to affect a fairly large area of skin. This condition is usually due to an infection of the skin with bacteria.

What are the signs and symptoms of the infection? 
This condition may cause:
  • fever
  • skin redness
  • pain and tenderness of the skin
  • increased warmth of the skin
  • skin swelling
What are the causes and risks of the infection? 
This condition is usually caused by a break in the skin that becomes infected with bacteria. It can also occur when there is no obvious break in the skin. People with diabetes have a higher risk of this condition.

What can be done to prevent the infection? 
Any breaks in the skin, such as cuts, bites, or scratches, should be cleaned with soap and water before applying a bandage. The area should be kept clean until the skin has healed over.

People with diabetes need to be careful with wounds to their feet or legs. People with diabetes are advised to inspect their feet on a regular basis. Diabetes causes neuropathy, or nerve damage, which can result in a lack of feeling in the legs and feet. People with diabetes may not be aware of a foot injury because they cannot feel it. Diabetes also causes poor circulation, which means wounds do not heal well. This condition is therefore more difficult to treat in people with diabetes. For more information, articles on diabetic foot care and diabetic foot ulcer can be read.

How is the infection diagnosed? 
The history and physical examination are used to make the diagnosis. There is no one test that can confirm the diagnosis. In some cases, blood tests and special x-ray tests may be used to make sure there is not a deeper, more serious infection present.

What are the long-term effects of the infection? 
If this condition is not treated, it can get worse. Some cases can become deeper, more serious infections of the tissue under the skin. This can lead to serious effects, including loss of a limb and even death. Many cases of foot and leg amputation in people with diabetes start out as cellulitis.

What are the risks to others? 
There are no risks to other persons as this condition is not contagious.

What are the treatments for the infection? 
For mild, superficial infections, oral antibiotics, such as cephalexin, flucloxacillin or dicloxacillin are often used. Over-the-counter pain medication can be used for pain. For more severe infections, individuals may need intravenous (IV) antibiotics.

This condition may get worse even with treatment, which is fairly common in people with diabetes. In this setting, more aggressive treatment may be needed. This may include surgery to remove dead skin or even bone.

What are the side effects of the treatments? 
Antibiotics commonly cause upset stomach, diarrhoea, or allergic reactions, such as skin rash or itching. Other side effects depend on the drug used. Surgery may cause bleeding or new infections to occur.

What happens after treatment for the infection? 
In most cases, this condition goes away after treatment. If treatment is successful, people can usually return to normal activities.

How is the infection monitored? 
Symptoms and physical examination are used to follow the condition. In some cases, special x-ray tests may be used if a deeper infection is suspected.

Author: Deirdre Monroe, RPh
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request
 


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