What is the definition of Cellulitis?

Cellulitis is a common skin infection caused by bacteria. It affects the middle layer of the skin (dermis) and the tissues below. Sometimes, muscle can be affected.

What are the alternative names for Cellulitis?

Skin infection - bacterial; Group A streptococcus - cellulitis; Staphylococcus - cellulitis

What are the causes for Cellulitis?

Staphylococcus and streptococcus bacteria are the most common causes of cellulitis.

Normal skin has many types of bacteria living on it. When there is a break in the skin, these bacteria can cause a skin infection.

Risk factors for cellulitis include:

• Cracks or peeling skin between the toes
• History of peripheral vascular disease
• Injury or trauma with a break in the skin (skin wounds)
• Insect bites and stings, animal bites, or human bites
• Ulcers from certain diseases, including diabetes and vascular disease
• Use of corticosteroid medicines or other medicines that suppress the immune system
• Wound from a recent surgery

What are the symptoms for Cellulitis?

Symptoms of cellulitis include:

• Fever with chills and sweating
• Fatigue
• Pain or tenderness in the affected area
• Skin redness or inflammation that gets bigger as the infection spreads
• Skin sore or rash that starts suddenly, and grows quickly in the first 24 hours
• Tight, glossy, stretched appearance of the skin
• Warm skin in the area of redness
• Muscle aches and joint stiffness from swelling of the tissue over the joint
• Nausea and vomiting

What are the current treatments for Cellulitis?

You will likely be prescribed antibiotics to be taken by mouth. You may be given pain medicine as well, if needed.

At home, raise the infected area higher than your heart to reduce swelling and speed up healing. Rest until your symptoms improve.

You may need to stay in a hospital if:

• You are very sick (for example, you have a very high temperature, blood pressure problems, or nausea and vomiting that does not go away)
• You have been on antibiotics and the infection is getting worse (spreading beyond the original pen marking)
• Your immune system is not working well (due to cancer, HIV)
• You have an infection around your eyes
• You require antibiotics through a vein (IV)

What is the outlook (prognosis) for Cellulitis?

Cellulitis usually goes away after taking antibiotics for 7 to 10 days. Longer treatment may be needed if cellulitis is more severe. This may occur if you have a chronic disease or your immune system is not working properly.

People with fungal infections of the feet may have cellulitis that keeps coming back, especially if you have diabetes. Cracks in the skin from the fungal infection allow the bacteria to get into the skin.

What are the possible complications for Cellulitis?

The following may result if cellulitis isn't treated or treatment doesn't work:

• Blood infection (sepsis)
• Bone infection (osteomyelitis)
• Inflammation of the lymph vessels (lymphangitis)
• Inflammation of the heart (endocarditis)
• Infection of the membranes covering the brain and spinal cord (meningitis)
• Shock
• Tissue death (gangrene)

When should I contact a medical professional for Cellulitis?

Call your provider right away if:

• You have symptoms of cellulitis
• You are being treated for cellulitis and you develop new symptoms, such as persistent fever, drowsiness, lethargy, blistering over the cellulitis, or red streaks that spread

How do I prevent Cellulitis?

Protect your skin by:

• Keeping your skin moist with lotions or ointments to prevent cracking
• Wearing shoes that fit well and provide enough room for your feet
• Learning how to trim your nails to avoid harming the skin around them
• Wearing appropriate protective equipment when participating in work or sports

Whenever you have a break in the skin:

• Clean the break carefully with soap and water. Apply an antibiotic cream or ointment every day.
• Cover with a bandage and change it every day until a scab forms.
• Watch for redness, pain, drainage, or other signs of infection.

REFERENCES

Habif TP. Bacterial infections. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 9.

Heagerty AHM, Harper N. Cellulitis and erysipelas. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier Saunders; 2018:chap 40.

Pasternak MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 95.