Cellulitis: Treatments, Causes, Symptoms

Cellulitis

• Cellulitis is a spreading subcutaneous inflammation caused by haemolytic Streptococci that produce hyaluronidase and streptokinase. This leads to the spreading of inflammatory exudates in the subcutaneous and fascial planes, resulting in a gross swelling of the affected part.
• Cellulitis spreads quickly in areas of loose subcutaneous tissue, such as the scrotum, or in areas of loose connective and interstitial tissue, such as the face and forearm.

Cellulitis Sources of Infection

• Injury—minor or major
• Graze or scratch or abrasion
• Snakebite, scorpion bite, etc

Cellulitis Precipitating Factors

• Diabetes
• The low resistance of an individual

Cellulitis Common Sites

• Lower limbs
• Face and neck
• Scrotum

Cellulitis Clinical Features

The affected part shows evidence of inflammation such as redness, itching, and diffuse swelling. Skin is stretched and shiny. Pain, fever, and toxaemia follow later. It is differentiated from an abscess by the features mentioned. In untreated cases, suppuration, sloughing, and gangrene may occur.

Cellulitis Treatment

• Bed rest with legs elevated to reduce oedema of legs.
• Glycerine MgSO4 dressing—reduces oedema of the part by osmotic effect.
• Diabetes mellitus, if present, is treated with an injection of insulin given subcutaneously.
• Appropriate antibiotics such as injection cephalosporins have to be given.
• Amoxycillin clavulanate potassium 25–40 mg or kg or day every 12 hours for 5–7 days depending on the severity of the condition.
• Antisnake venom is given in cases of snakebite.

Cellulitis Complications

1. Cellulitis may turn into an abscess which needs to be drained.
2. Necrotising fasciitis: Certain highly invasive strains of Streptococcus pyogenes may cause extensive necrosis of the skin and subcutaneous tissues, resulting in necrotising fasciitis. This is treated by debridement and skin grafting.
3. Toxaemia and septicaemia: Streptococcal toxic shock syndrome may result if exotoxins are produced by the organisms.
4. Cellulitis may precipitate ketoacidosis in patients with diabetes mellitus.