Cellulitis: Causes, Symptoms, Diagnosis & Treatments
Cellulitis is a skin infection that occurs when bacteria enter through a breach in the skin barrier. Celulitis is characterized by skin erythema, edema, and warmth. Cellulitis involves the deeper dermis and subcutaneous fat. Cellulitis is frequently found in middle-aged and elderly people, and incidence is 200 cases per 100,000 patient years. The predisposing factors of cellulitis include wound-like trauma, inflammation, original skin infections such as tinea pedis, varicella, edema, and the like.
Causes
The most common cellulitis pathogen is beta-hemolytic streptococci and S. aureus. In one study, 73% of beta-hemolytic streptococci were admitted to 179 nonpurulent cellulitis. The response rate of the beta-lactam antibiotic was 96%. Less common pathogens include H. influenza, clostridia, non-spore forming anaerobes, pneumococcus, and meningococcus.
Symptoms
Patients with cellulitis usually indolent the development of symptoms and gradually develop a localized symptom over the course of several days. It occurs more in the lower extremities than in the upper extremities. In addition, lymphangitis and regional lymph node inflammation occur well in cellulitis patients.
Diagnosis
Diagnosis of cellulitis is based on clinical manifestation. The characteristic skin erythema, edema, and warmth of Cellulitis are suspected. Blood culture, needle aspiration, and skin biopsy are not required for mild infection. Blood culture is actually positive at less than 5% of cases. Needle aspiration culture results are very variable and pathogen is found in 2 ~ 30% of skin biopsy culture. Culture of blood, pus, or bullae is performed when there is systemic toxicity, extensive skin involvement, or underlying comorbidity. For example, if you have tinea pedis, culture is useful. In one study, 83% of patients with cellulitis had tinea pedis and 85% of cases had beta hemolytic streptococci when cultured.
Treatments
Non-antibiotic therapy for cellulitis is primarily the treatment of the affected area and underlying disease. For example, if cellulitis is present on the feet, it can promote the gravity drainage of edema and inflammatory substances by lying down and lifting the feet. The skin should also be hydrated enough to prevent drying and cracking. Many patients with cellulitis have underlying conditions that can cause recurrent cellulitis. In such patients, therapy should target both cellulitis and the underlying condition.
The main treatment for cellulitis is antibiotics. Patients with mild cellulitis should be treated with oral antibiotics and use parenteral antibiotics for systemic toxicity, immunocompromise, abnormal anatomy, and progression of symptoms despite 48-72 hours of oral therapy. Which antibiotic is used depends on whether the patient's cellulitis is purulent or nonpurulent. Infection with purulence is often due to S. aureus infection, and empirical antibiotics may be appropriate for MRSA. Patients with cellulitis develop symptoms within 24 to 48 hours of starting antibiotic treatment, which can take up to 72 hours to be visualized. In general, uncomplicated cellulitis is sufficient for 5 days of therapy.
Non-purulent cellulitis can be treated according to beta-hemolytic streptococci and MSSA. For example, cephalexin. However, patients who do not respond well to initial treatment should be treated according to MRSA and trimethoprim-sulfamethoxazole can be used.
In this case, we were hospitalized with left foot swelling as an antibiotic. We did not have any effect on PO anti medication in the local area. IV anti is cefazolin, ceftriaxone, teicoplanin, and dexamethasone is used for anti-inflammatory effect.
Causes
The most common cellulitis pathogen is beta-hemolytic streptococci and S. aureus. In one study, 73% of beta-hemolytic streptococci were admitted to 179 nonpurulent cellulitis. The response rate of the beta-lactam antibiotic was 96%. Less common pathogens include H. influenza, clostridia, non-spore forming anaerobes, pneumococcus, and meningococcus.
Symptoms
Patients with cellulitis usually indolent the development of symptoms and gradually develop a localized symptom over the course of several days. It occurs more in the lower extremities than in the upper extremities. In addition, lymphangitis and regional lymph node inflammation occur well in cellulitis patients.
Diagnosis
Diagnosis of cellulitis is based on clinical manifestation. The characteristic skin erythema, edema, and warmth of Cellulitis are suspected. Blood culture, needle aspiration, and skin biopsy are not required for mild infection. Blood culture is actually positive at less than 5% of cases. Needle aspiration culture results are very variable and pathogen is found in 2 ~ 30% of skin biopsy culture. Culture of blood, pus, or bullae is performed when there is systemic toxicity, extensive skin involvement, or underlying comorbidity. For example, if you have tinea pedis, culture is useful. In one study, 83% of patients with cellulitis had tinea pedis and 85% of cases had beta hemolytic streptococci when cultured.
Treatments
Non-antibiotic therapy for cellulitis is primarily the treatment of the affected area and underlying disease. For example, if cellulitis is present on the feet, it can promote the gravity drainage of edema and inflammatory substances by lying down and lifting the feet. The skin should also be hydrated enough to prevent drying and cracking. Many patients with cellulitis have underlying conditions that can cause recurrent cellulitis. In such patients, therapy should target both cellulitis and the underlying condition.
The main treatment for cellulitis is antibiotics. Patients with mild cellulitis should be treated with oral antibiotics and use parenteral antibiotics for systemic toxicity, immunocompromise, abnormal anatomy, and progression of symptoms despite 48-72 hours of oral therapy. Which antibiotic is used depends on whether the patient's cellulitis is purulent or nonpurulent. Infection with purulence is often due to S. aureus infection, and empirical antibiotics may be appropriate for MRSA. Patients with cellulitis develop symptoms within 24 to 48 hours of starting antibiotic treatment, which can take up to 72 hours to be visualized. In general, uncomplicated cellulitis is sufficient for 5 days of therapy.
Non-purulent cellulitis can be treated according to beta-hemolytic streptococci and MSSA. For example, cephalexin. However, patients who do not respond well to initial treatment should be treated according to MRSA and trimethoprim-sulfamethoxazole can be used.
In this case, we were hospitalized with left foot swelling as an antibiotic. We did not have any effect on PO anti medication in the local area. IV anti is cefazolin, ceftriaxone, teicoplanin, and dexamethasone is used for anti-inflammatory effect.
