Cellulitis is a potentially serious bacterial infection of your skin. Cellulitis appears as a swollen, red area of skin that feels hot and tender, and it may spread rapidly.

Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of your body. Cellulitis may be superficial - affecting only the surface of your skin - but cellulitis may also affect the tissues underlying your skin and can spread to your lymph nodes and bloodstream.

Causes of Cellulitis

Cellulitis is usually caused by a bacterial infection of a wound or area of skin that is no longer intact. The most common bacterial causes of cellulitis include the following:

group A - hemolytic streptococcus
Streptococcus pneumoniae
Staphylococcus aureus

Other causes may include human or animal bites, or injuries that occur in water.

Signs and Symptoms of Cellulitis

Cellulitis may result in skin that is:

Red
Swollen
Tender
warm skin
pain
bruising
blisters
fever
headache
chills
feeling weak

The changes in your skin may be accompanied by a fever. Over time, the area of redness tends to expand. Small red spots may appear on top of the reddened skin, and less commonly, small blisters may form and burst.

Diagnosis of Cellulitis

Diagnosis is usually based on a medical history and physical examination. Blood and skin samples may be taken to confirm the diagnosis and the type of bacteria that is present.

Risk factors of Cellulitis

Risk factors for cellulitis include:

Insect bites and stings, animal bite, or human bite
Injury or trauma with a break in the skin (skin wounds)
History of peripheral vascular disease
Diabetes -related or ischemic ulcers
Recent cardiovascular, pulmonary (lung), dental or other procedures
Use of immunosuppressive or corticosteroid medications

Treatment of Cellulitis

Cellulitis is treated with antibiotics. Your doctor will choose a specific antibiotic depending on the location of your cellulitis and the likely cause of your infection. Most cases of cellulitis improve quickly once antibiotics are given.

Mild cellulitis can be treated at home with antibiotics taken by mouth. However, you must keep in close contact with your doctor to be sure that the infection is improving as expected. At home, warm compresses, such as a warm, moist washcloth, and elevation of the infected area can help. If you have severe cellulitis, you may need to be treated in the hospital with antibiotics given intravenously.

Most patients can be treated with oral antibiotics at home. However if there are signs of systemic illness or extensive cellulitis, treatment may require hospital admission for initial intravenous antibiotics. Treatment for uncomplicated cellulitis is usually for 10 to 14 days but antibiotics should be continued until all signs of infection have cleared (redness, pain and swelling) - sometimes for several months.

Oral antibiotics used commonly are penicillin, flucloxacillin, cefuroxime, or erythromycin. The usual intravenous antibiotics used are penicillin-based antibiotics (e.g. penicillin G or flucloxacillin) or cephalosporins (e.g. cefotaxime or cephazolin). In situations where a broader antibiotic cover is required, for example a diabetic patient with a foot ulcer complicated by cellulitis, amoxycillin and clavulanic acid may be used. Clindamycin and vancomycin are alternative antibiotics in patients with serious penicillin allergy.

Prevention tips

Avoid skin damage by wearing appropriate protective equipment when participating in work or sports. Also clean any breaks in the skin carefully and watch for redness, pain, drainage, or other signs of infection.

Maintain good general health and control chronic medical conditions. A body that is healthy can more easily fight bacteria before they multiply and cause infection, while a body that is run down has less protection against infection.

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