Infectious Cellulitis
Why does infectious cellulitis occur? All the information about this condition: causes, symptoms, and treatment.
Symptoms and Causes
Infectious cellulitis is an acute bacterial infection that affects the skin and subcutaneous tissue. It is usually unilateral and develops on the skin of the lower leg, although it can appear in any area of the body. It is a very common condition that typically has a good prognosis, but if not treated promptly, it can become very serious.
Symptoms
Common symptoms of infectious cellulitis include:
- Pain and tenderness in the affected area.
- Redness.
- Swelling.
- Irritation or spreading rash.
- Warmth.
- Skin surface with an orange peel appearance.
- Red streaks.
- Fever.
- Occasionally, ulcers or purulent blisters (purulent cellulitis).
If cellulitis worsens, general malaise, muscle pain, sweating, dizziness, or lethargy may appear.
Causes
The bacteria most commonly responsible for infectious cellulitis are Streptococcus pyogenes and Staphylococcus aureus, which are typically found on the skin and mucous membranes, entering the body through an existing skin injury, such as open wounds, burns, cuts, eczema, or abscesses.
Less commonly, cellulitis can be caused by other bacteria in specific contexts:
- Group B streptococci, in older adults with diabetes.
- Gram-negative bacilli, in children.
- Pseudomonas aeruginosa, in people with diabetes or neutropenia, hospitalized patients, or hot tub users.
- Pasteurella multocida, transmitted by a cat bite.
- Capnocytophaga, from a dog bite.
Risk Factors
The likelihood of developing infectious cellulitis increases in the following cases:
- Presence of wounds or injuries on the skin.
- Skin conditions that cause eczema or wounds, such as atopic dermatitis, athlete's foot, diabetic foot, or shingles.
- A history of cellulitis.
- Lymphedema: chronic swelling in the limbs.
- Weakened immune system.
- Overweight.
Complications
If infectious cellulitis is not treated promptly, it progresses very quickly and can lead to tissue necrosis, potentially resulting in gangrene, which, if worsened, may require amputation. Additionally, the infection can spread to other parts of the body through the lymphatic system and bloodstream, causing various disorders that can pose a life risk:
- Sepsis: The immune system reacts disproportionately to the infection, which can cause multiple organ dysfunction and a decrease in blood pressure (septic shock), potentially fatal.
- Osteomyelitis: Bone infection that can cause bone necrosis.
- Endocarditis: Inflammation of the myocardium, the lining of the heart chambers and valves. It can lead to heart failure or a stroke.
- Meningitis: Inflammation of the meninges, the membranes covering the brain and spinal cord. It is a potentially life-threatening medical emergency that can result in severe physical and neurological sequelae.
- Toxic shock syndrome: Causes multi-organ failure with a high mortality rate.
- Necrotizing fasciitis: Infection and necrosis of subcutaneous tissue and fascia, the connective tissue covering all body structures. It is very aggressive and generally has a fatal prognosis.
Furthermore, recurrent infectious cellulitis is common. Recurrent cellulitis can eventually damage the lymphatic drainage system, leading to chronic swelling in the affected area.
Prevention
The most effective way to prevent infectious cellulitis is by properly caring for and protecting the skin, especially in the case of injuries:
- Keep the skin clean and hydrated.
- Clean and disinfect wounds properly with water and soap.
- Use protective creams or lotions for wounds.
- Cover wounds with a clean bandage and change it frequently.
- Seek medical attention if signs of infection appear.
- If you have diabetes or circulatory disorders, extra care should be taken by thoroughly examining the skin for lesions or signs of infection to treat them immediately and wearing protective footwear or gloves when necessary.
What doctor treats infectious cellulitis?
Infectious cellulitis is diagnosed and treated in family medicine, internal medicine, and dermatology consultations.
Diagnosis
Infectious cellulitis is typically diagnosed by observing the physical symptoms present on the skin. However, to confirm the diagnosis or assess its severity, the following tests may be performed:
- Blood tests: Help identify infection markers, such as elevated levels of white blood cells and C-reactive protein or high erythrocyte sedimentation rate. The specific causative bacteria may also be detected.
- Skin tissue culture: The bacterial agent can be identified in a sample of the affected tissue grown in the laboratory.
- Imaging diagnostic tests, if complications such as osteomyelitis, internal abscesses, or necrotizing fasciitis are suspected.
Treatment
The treatment for infectious cellulitis may include several options:
- Administration of topical or oral antibiotics to eliminate the bacterial infection. In more severe cases, intravenous antibiotics are given.
- Pain relievers to alleviate discomfort.
- Rest, keeping the leg elevated and applying cold compresses to the affected area to reduce swelling and heat.
- Surgical drainage: In case of abscesses, they may need to be drained to remove infected fluid.
