Presentation
The condition can appear red or hot or edematous, but venous stasis dermatitis almost always presents bilaterally. Usually the left leg is more edematous, compared with the right leg. [mdedge.com]
Photographs of the lower extremities of a 70-year-old male kidney transplant recipient who presented with bilateral lower extremity erythema, swelling, and pain. Figure 1. [academic.oup.com]
We present a case of posttraumatic fat necrosis, demonstrating some pitfalls in the process of diagnosis. 1. [hindawi.com]
However, in cases of lower leg cellulitis audited subsequent to local presentation of our results, the prevalence of toeweb maceration recorded in case records remains low (15/106 patients, 14%). [bmj.com]
He presented oliguric with rising BUN and Creatinine. [casesjournal.biomedcentral.com]
Entire Body System
- Fever
Fever, chills, lethargy, irritability, headache, confusion, body aches and discomfort are common symptoms of facial cellulitis. Loss of appetite, nausea and vomiting may also occur. Fever may cause a rise in the pulse rate known as tachycardia. [livestrong.com]
Signs and symptoms include pain, tenderness and reddening in the affected area, fever, chills, and lymphadenopathy. [fpnotebook.com]
Usually when the fever is continuously repeated with vomiting, higher doses of amoxicillin is given directly into the veins with doses of phenoxymethylpenicillin which is given orally. [articles4health.net]
Lymphatic vessels may occasionally be involved, and the person may have a fever and feel tired.The legs and face are the most common sites involved, though cellulitis can occur on any part of the body. [play.google.com]
Some may have a fever, chills, rapid heart rate, headache, low blood pressure, and confusion, which usually indicates a severe infection. [msdmanuals.com]
- Lymphedema
Congenital lymphedema can also be found as part of Turner and Noonan syndromes. Lymphedema praecox, also known as Meige's disease, is the most common form of primary lymphedema. [casesjournal.biomedcentral.com]
Good health – Canada MALE (Male Advocate for LymphEdema) | FB: Lymphedema – LE Nexus Canada ✌️ On the eve of “Lymphedema Month”, wishing all a healthy #WLD – 6 March It’s Lymphedema Awareness Month. [lymphiestrong.com]
In addition, chronic lymphedema can be confused with bilateral cellulitis. Patients can develop very large extremities with lymphedema. For those with little medical experience, seeing a case of unilateral or bilateral lymphedema can be shocking. [thehappyhospitalist.blogspot.com]
Patients with lymphedema or chronic edema are more prone to infection due to damage to lymphatic vessels and immune deficiency in that area. [physio-pedia.com]
- Malaise
The latest in our series by GP and hospital practitioner Dr Andy Jordan on differentiating two often similar-looking skin conditions Cellulitis of lower leg • Occurs in adults – more likely in the elderly • Associated with fever and malaise, which usually [pulsetoday.co.uk]
There is generally no systemic upset or malaise. [independentnurse.co.uk]
[…] stretched skin Small pimples or blisters on the skin If the condition is not treated promptly, the bacteria can affect deeper layers of the skin and may cause more serious signs and symptoms, including chills, shaking, fatigue, dizziness, muscle pain, malaise [docdoc.com.sg]
Fever and a general sick feeling (malaise) often accompany cellulitis. Severe infections can cause low blood pressure if bacteria get into the bloodstream. [drugs.com]
- Streptococcal Infection
Cellulitis is a common streptococcal infection with easy-to-measure objective features and has been used in this trial as a representative streptococcal infection. [bmjopen.bmj.com]
[…] deeper tissues, like the muscle or bone Long-term swelling of the affected site due to lymphatic vessel damage Increased likelihood of further cellulitis or erysipelas at the same site Kidney damage following streptococcal infection Meningitis following [bad.org.uk]
Skin Diseases, Infectious Infection Suppuration Connective Tissue Diseases Inflammation Pathologic Processes Streptococcal Infections Gram-Positive Bacterial Infections Bacterial Infections Skin Diseases, Bacterial Skin Diseases Anti-Bacterial Agents [clinicaltrials.gov]
The streptococcal infection known as flesh-eating bacterial infection is an example of fasciitis. Cellulitis, when untreated, may rarely spread to the deeper tissues and cause serious fasciitis. [medicinenet.com]
- Fishing
J.Biol.Chem. 266 16507 PMID: 1885582 Fujita and Yoshikawa (1999) LKPNM: a prodrug-type ACE-inhibitory peptide derived from fish protein. Immunopharmacology. 44 123 PMID: 10604535 If you know of a relevant reference for Captopril, please let us know. [tocris.com]
If the cellulitis is caused after an injury from shellfish or saltwater fish then the bacteria responsible is Erysipelothrix rhusiopathiae. Cellulitis can also be caused after skin injury on farms, particularly if you work in poultry with pigs. [newhealthadvisor.com]
Exposure to environmental factors: These include polluted water and some animals, including fish and reptiles. [medicalnewstoday.com]
Neutropenia Cirrhosis (Child-Pugh class B or C) Intravenous drug use Human or animal bite Skin laceration acquired in fresh or salt open water Fish fin or bone injuries Information from the National Library of Medicine To learn more about this study, [clinicaltrials.gov]
— Pernille, 3 x Survivor Fish slayer & cellulitis survivor!!!! Overall BADASS….. LOL. Justin missed hunting season due to a bout back in November. I’ve had cellulitis twice – both before LE ever showed up. [lymphiestrong.com]
Gastrointestinal
- Vomiting
Loss of appetite, nausea and vomiting may also occur. Fever may cause a rise in the pulse rate known as tachycardia. If facial cellulitis continues to spread unchecked, blood pressure can drop to dangerously low levels and shock may occur. [livestrong.com]
Contact your doctor immediately if your symptoms get worse 48 hours after taking the antibiotics, or you develop additional symptoms, such as a high temperature or vomiting. [your.md]
In more severe cases, cellulitis can also be accompanied – and often preceded – by: a high temperature (fever) of 38C (100.4F) or above vigorous shaking (rigors) nausea and vomiting dizziness confusion These are signs that the infection has spread deeper [nhsinform.scot]
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 [medlineplus.gov]
Usually when the fever is continuously repeated with vomiting, higher doses of amoxicillin is given directly into the veins with doses of phenoxymethylpenicillin which is given orally. [articles4health.net]
- Loss of Appetite
Loss of appetite, nausea and vomiting may also occur. Fever may cause a rise in the pulse rate known as tachycardia. If facial cellulitis continues to spread unchecked, blood pressure can drop to dangerously low levels and shock may occur. [livestrong.com]
Sepsis is recognised by fever, malaise, loss of appetite, nausea, lethargy, headache, aching muscles and joints. [dermnetnz.org]
[…] of taste loss of appetite nausea vomiting dry mouth sores inside your mouth or on your lips numbness in the hands or feet kidney failure increased levels of potassium in the blood high blood pressure severe allergic reaction enlarged breast in men (gynecomastia [rxlist.com]
[…] of appetite staring expression very sleepy and reluctant to wake up Bacterial meningitis is very serious and should be treated as a medical emergency. [hse.ie]
Skin
- Warm Skin
[…] 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 Joint stiffness from swelling of the tissue over [medlineplus.gov]
The following are the common symptoms of cellulitis: • Swelling of the skin • Warm skin • Tenderness • Bruising • Pain • Blisters • Headache • Fever • Chills • Weakness • Red streaks from the original site of the cellulitis Some cases of cellulitis are [dermatology.columbia.edu]
They can include: Skin that is swollen, painful, or warm Skin that looks red, bruised, dimpled, or blistered Swollen lymph glands (nodes) nearby Swollen lymph vessels nearby, appearing as red streaks on the skin Fever and chills High heart rate Low blood [urmc.rochester.edu]
Common symptoms include: Redness of the skin Swelling of the skin Tenderness Warm skin Pain Bruising Blisters Fever Headache Chills Weakness Red streaks from the original site of the cellulitis Some cases of cellulitis are an emergency. [hopkinsmedicine.org]
- Flushing
Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including captopril [medicinenet.com]
Drink at least eight glasses of water every day as this helps in flushing out harmful organisms and toxins from the body that may cause cellulitis and other types of infections. [docdoc.com.sg]
Common captopril side effects may include: cough; flushing (warmth, redness, or tingly feeling); numbness, tingling, or burning pain in your hands or feet; loss of taste sensation; or mild skin itching or rash. [drugs.com]
However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. [medlineplus.gov]
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. [webmd.com]
- Foot Ulcer
ABC of wound healing: Diabetic foot ulcers. BMJ 2006;332:407. Das DK, Baker MG, Venugopal K. Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review. BMC Infect Dis 2012;12:348. [bpac.org.nz]
Neurologic
- Irritability
Fever, chills, lethargy, irritability, headache, confusion, body aches and discomfort are common symptoms of facial cellulitis. Loss of appetite, nausea and vomiting may also occur. Fever may cause a rise in the pulse rate known as tachycardia. [livestrong.com]
Any skin irritant can increase the chances of a cellulitis infection. Managing prior skin conditions is also important to reduce the chances of cellulitis. Credit image: GetStencil.com Last article update: 03/04/2019 [ecellulitis.com]
The most common disorders mistaken for lower limb cellulitis include venous eczema, lipodermatosclerosis, irritant dermatitis, and lymphedema. [ncbi.nlm.nih.gov]
Keep any chemical products or skin irritants off the affected area (perfume, scented body soaps, detergents, lotions, etc.). [draxe.com]
- Headache
Symptoms to diagnose cellulitis: Symptoms of cellulitis of leg include skin sore, reddening and tightening of the skin around the affected area, headache. [articles4health.net]
Fever, chills, lethargy, irritability, headache, confusion, body aches and discomfort are common symptoms of facial cellulitis. Loss of appetite, nausea and vomiting may also occur. Fever may cause a rise in the pulse rate known as tachycardia. [livestrong.com]
The following are the common symptoms of cellulitis: • Swelling of the skin • Warm skin • Tenderness • Bruising • Pain • Blisters • Headache • Fever • Chills • Weakness • Red streaks from the original site of the cellulitis Some cases of cellulitis are [dermatology.columbia.edu]
Symptoms may include fever, shivers, muscular aches and pains, headache, nausea, vomiting etc. The swollen area then develops a rash or becomes red, hot and tender to the touch. [lymphoedema.org]
These symptoms may be accompanied by fever, headache, chills, weakness and fatigue. Red streaks may spread out from the original site — an indication that the infection is invading more tissue. [sheknows.com]
- Meningism
Corticosteroids have been used as therapy for a number of infectious diseases, and steroid use has been shown to improve survival in patients with bacterial meningitis, tuberculous meningitis, tuberculous pericarditis, severe typhoid fever, tetanus, or [the-hospitalist.org]
If facial cellulitis is left untreated in children, the bacteria can potentially spread to the outer membranes of their brain (the meninges) and trigger a serious brain infection called meningitis. [hse.ie]
The most severe complications of cellulitis are meningitis and blood poisoning (if the bacteria get into the bloodstream, called bacteremia ). Meningitis can occur if the bacteria get inside the central nervous system (e.g., brain or spinal cord). [chealth.canoe.com]
- Lethargy
Fever, chills, lethargy, irritability, headache, confusion, body aches and discomfort are common symptoms of facial cellulitis. Loss of appetite, nausea and vomiting may also occur. Fever may cause a rise in the pulse rate known as tachycardia. [livestrong.com]
[…] covering the brain and spinal cord ( meningitis ) Shock Tissue death ( gangrene ) 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 [medlineplus.gov]
Cellulitis can also cause fever, chills, sweat, fatigue, lethargy, blistering, dizziness or muscle aches. These symptoms could mean that the cellulitis infection is spreading or becoming more serious. [livescience.com]
[…] meningitis) Shock Tissue death (gangrene) When to Contact a Medical Professional 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 [pennmedicine.org]
Sepsis is recognised by fever, malaise, loss of appetite, nausea, lethargy, headache, aching muscles and joints. [dermnetnz.org]
- Forgetful
Keep the wound covered with bandage/plaster but don't forget to change it regularly. Keep your skin moisturized as dry skin can get cracked easily which results in entering of bacteria into the skin. Regularly use a moisturizer for your skin. [newhealthadvisor.com]
If you forget to take a dose at your usual time, take it as soon as you remember. If when you remember, it is nearly time for your next dose then take your next dose when it is due but leave out the missed dose. [patient.info]
Whether you have survived 1 bout or 100, you know it is an experience you will never ever forget in your lifetime. [lymphiestrong.com]
What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time. [healthline.com]
But I think the second GP I saw had a background in, I forget the technical name, said: “I think we ought to get your bloods checked.” And so he checked them and, I remember, he confirmed that it was cellulitis.’ [bjgp.org]
Workup
Workup for a secondary cause of lymphedema in our patient was negative. He did not have a history of malignancy, recurrent cellulitis/dermatitis, or trauma to his extremity. [casesjournal.biomedcentral.com]
Microbiology
- Erysipelothrix Rhusiopathiae
If the cellulitis is caused after an injury from shellfish or saltwater fish then the bacteria responsible is Erysipelothrix rhusiopathiae. Cellulitis can also be caused after skin injury on farms, particularly if you work in poultry with pigs. [newhealthadvisor.com]
Laboratory
- Leukocytosis
Investigations may reveal: Leukocytosis (raised white cell count). Elevated C-reactive protein ( CRP ) Causative organism, on culture of blood or of pustules, crusts, erosions or wound Imaging may be performed. [dermnetnz.org]
Treatment
Resulting in: Up to a 50% reduction in treatment time compared to using antibiotics alone. Improve patient outcome, reduce recovery rates, reduce the cost of successful treatment. Prevent hospital admission for treatment. [vibrantmedical.co.uk]
Treatment Options The most common treatment for leg cellulitis is a round of antibiotics. A medical professional can confirm the presence of bacteria to diagnose the condition. [ecellulitis.com]
Although antimicrobial treatment was often started, clinical signs resolved also in 9 patients without antimicrobial treatment. To prevent recurrencies penicillin prophylaxis was given to 23 patients. [ncbi.nlm.nih.gov]
Prognosis
The prognosis is generally good, but the condition can return, especially in people with poor circulation, chronic (long-term) swelling in the legs or skin that is in poor condition. [drugs.com]
[…] 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) Outlook (Prognosis [pennmedicine.org]
What is the outlook/prognosis for cellulitis? What are complications of cellulitis? Cellulitis is a treatable condition, but antibiotic treatment is necessary to eradicate the infection and avoid complications and spread of the infection. [medicinenet.com]
Etiology
The etiology and pathogenesis of recurrent ALC is discussed. [ncbi.nlm.nih.gov]
Evidence indicates that lymphedema, no matter the etiology, is susceptible to cellulitis with both great propensity and virulence. [casesjournal.biomedcentral.com]
The etiologic agents are most often Streptococcus pyogenes and Staphylococcus aureus, followed by non—group A β-hemolytic streptococci and gram-negative bacilli [ 1, 2 ]. [academic.oup.com]
See: illustration ; necrotizing fasciitis Etiology Bacteria gain access through breaks in the skin and spread rapidly, overwhelming normal body defenses; lesions between the toes from athlete's foot are common entry sites. [medical-dictionary.thefreedictionary.com]
Epidemiology
SOURCES: Hywel Williams, Ph.D., professor, dermato-epidemiology, University of Nottingham, England; Michele Green, M.D., dermatologist, Lenox Hill Hospital, New York City; May 2, 2013, New England Journal of Medicine [consumer.healthday.com]
[…] training students within the Department of Internal Medicine, as well as teaching infectious diseases and microbiology courses at other departments at the University of Michigan including the Department of Ecology and Evolutionary Biology, Department of Epidemiology [med.umich.edu]
Epidemiology and outcomes of complicated skin and soft tissue infections in hospitalized patients. J Clin Microbiol. 2012;50(2):238-45. [woundcareadvisor.com]
The parameters of interest in the study were: epidemiological, clinical, microbial and therapeutic aspects. Data were recorded and analyzed statistically using the software SPSS evaluating free version. [ncbi.nlm.nih.gov]
Pathophysiology
View Article PubMed Google Scholar Kerchner K, Fleischer A, Yosipovitch G: Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 2008, 59 (2): 324-331. 10.1016/j.jaad.2008.04.013. [casesjournal.biomedcentral.com]
Cellulitis: Practice Essentials, Background, Pathophysiology. https://emedicine.medscape.com/article/214222-overview. [top10homeremedies.com]
"Thrombotic risk factors: basic pathophysiology". Critical Care Medicine. 38 (2 Suppl): S3-9. doi:10.1097/CCM.0b013e3181c9cbd9. PMID 20083911. ^ a b c d e f Bovill EG, van der Vliet A (2011). [en.wikipedia.org]
Although there is no reason to believe that the pathophysiology of cellulitis differs between patients who are hospitalized and those who are not, the association of the various risk factors with the disease may be different. [academic.oup.com]
Prevention
Although penicillin prophylaxis was successful in preventing the recurrence of ALC the risk-benefit ratio of this approach has not been ascertained. The etiology and pathogenesis of recurrent ALC is discussed. [ncbi.nlm.nih.gov]
Citation: Mason JM, Thomas KS, Crook AM, Foster KA, Chalmers JR, Nunn AJ, et al. (2014) Prophylactic Antibiotics to Prevent Cellulitis of the Leg: Economic Analysis of the PATCH I & II Trials. [journals.plos.org]
Information received on cellulitis causation, treatment, and prevention Table 3. [bjgp.org]
Immediate treatment is needed to prevent permanent vision loss from damage to the optic nerve, according to Q-Notes for Adult Medicine. [livestrong.com]