Cellulitis is best described as an infection of the skin along with the subcutaneous tissue. This infection can be instigated by various organisms but most commonly by the staphylococcus and streptococcus species. Always bear in mind that the skin is prone to infection from chronic skin issues, insect bites, animal bites or an open wound such as a scratch or cut. The infections can be mild or localized or can become widespread and progress into a systemic infection that oftentimes requires hospitalization.
What are the symptoms?
The initial indications of infection might include a localized area of redness in the skin with a clearly defined border. This area can be painful, warm and slightly elevated or swollen. As the infection progresses, the reddened area or erythema starts to spread out.
In most cases, swollen lymph nodes and fever can develop. The affected skin might also become firm which is called as induration. In some cases, the infection can progress to an abscess which is an accumulation of pus inside the skin. Once this occurs, there is an evident mass that is soft and filled with fluid.
In case cellulitis becomes severe, symptoms such as fever, chills, nausea, lightheadedness, vomiting or generalized malaise can occur. Low blood pressure and a rapid heart rate can occur which are indications that the infection became systemic.
If the area of inflammation is localized and spotted early, a topical antibiotic can be used. A cool compress is also recommended. In case cellulitis does not progress into a localized abscess, it requires incision and drainage. Even though cellulitis can develop on any part of the body, it typically affects the extremities. The individual should avoid vigorous use of the extremities and keep it elevated to help optimize the blood flow and lymphatic drainage to and from the infection site, thus promoting the healing process.
Once cellulitis becomes severe or extensive, systemic-based antibiotics are required. Since most of the germs responsible for triggering skin infections are streptococcus and staphylococcus, the medications directed at these organisms are usually used first.
It is important to note that there are some geographical regions that are known to have a higher likelihood of certain antibiotic resistance patterns which also guides the selection of the right medication.
The initial line of medications might include one of the various penicillin-type or cephalosporin-types. In case methicillin resistant staphylococcus aureus (MRSA) is suspected, medications such as doxycycline or a combined drug trimethoprim/sulfamethoxazole can be used. Remember that MRSA is resistant to penicillin and cephalosporin as well as other families of antibiotics occasionally. In case antibiotics are not effective, the individual should be admitted to the hospital so that intravenous medications such as vancomycin can be given.