Cellulitis
Classification & external resources

Infected left shin
ICD-10	L03.
ICD-9	682.9
DiseasesDB	29806
eMedicine	med/310  emerg/88 derm/464
MeSH	D002481

Cellulitis is an inflammation of the connective tissue underlying the skin, that can be caused by a bacterial infection. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken: cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, or sites of intravenous catheter insertion. The mainstay of therapy remains treatment with appropriate antibiotics. Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of the body. Cellulitis may be superficial — affecting only the surface of the skin — but cellulitis may also affect the tissues underlying the skin and can spread to the lymph nodes and bloodstream. Image File history File linksMetadata Size of this preview: 450 × 600 pixel Image in higher resolution (1224 × 1632 pixel, file size: 270 KB, MIME type: image/jpeg) Cellulitis case, my left knee infected. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // L00-L99 - Diseases of the skin and subcutaneous tissue (L00-L08) Infections of the skin and subcutaneous tissue (L00) Staphylococcal scalded skin syndrome (L01) Impetigo (L02) Cutaneous abscess, furuncle and carbuncle (L03) Cellulitis (L04) Acute lymphadenitis (L05) Pilonidal cyst (L08) Other local infections of skin and subcutaneous tissue (L081) Erythrasma... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Connective tissue is one of the four types of tissue in traditional classifications (the others being epithelial, muscle, and nervous tissue. ... Beyond overall skin structure, refer below to: See-also. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... An infection is the detrimental colonization of a host organism by a foreign species. ... In microbiology, flora (plural: floras or floræ) refers to the collective bacteria and other microorganisms in an ecosystem (usually an animal host or a single part of its body). ... Exogenous bacteria are bacteria introduced to closed biological systems from the external world. ... For the packaging type, see Blister pack. ... For other uses, see Burn. ... Insect bites and stings can cause an immediate skin reaction often resulting in redness and swelling in the injured area. ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Catheter disassembled In medicine, a catheter is a tube that can be inserted into a body cavity, duct or vessel. ... Staphylococcus aureus - Antibiotics test plate. ...

It is unrelated to cellulite, a cosmetic condition featuring dimpling of the skin. Cellulite. ...

Symptoms

Early symptoms may include fever, headache, nausea, and early signs of redness on the affected area. This article needs additional references or sources for verification. ... A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... For other uses, see Nausea (disambiguation). ...

Cellulitis is characterized by redness, swelling, warmth, and pain or tenderness. Cellulitis frequently occurs on exposed areas of the body such as the arms, legs, and face. Other symptoms can include fever or chills and headaches. In advanced cases of cellulitis, red streaks (sometimes described as 'fingers') may be seen traveling up the affected area. The swelling can spread rapidly. Look up ARM in Wiktionary, the free dictionary. ... Diagram of an insect leg A leg is the part of an animals body that supports the rest of the animal above the ground and is used for locomotion. ... This article needs additional references or sources for verification. ...

Cellulitis in a Limb showing typical red streaks and swelling

Image File history File linksMetadata Cellulitis_Left_Leg. ... Image File history File linksMetadata Cellulitis_Left_Leg. ...

Causes

Cellulitis is caused by a type of bacteria entering by way of a break in the skin. This break need not be visible. Group A streptococcus and staphylococcus are the most common of these bacteria, which are part of the normal flora of the skin but cause no actual infection until the skin is broken. Predisposing conditions for cellulitis include insect bite, animal bite, pruritic skin rash, recent surgery, athlete's foot, dry skin, eczema, burns and boils, though there is debate as to whether minor foot lesions contribute. Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... The group A streptococcus bacterium (Streptococcus pyogenes, or GAS) is a form of Streptococcus bacteria responsible for most cases of streptococcal illness. ... Streptococcus is a genus of spherical shaped Gram-positive bacteria, belonging to the phylum Firmicutes[1] and the lactic acid bacteria group. ... Species S. aureus S. caprae S. epidermidis S. haemolyticus S. hominis S. lugdunensis S. saprophyticus S. warneri S. xylosus Staphylococcus (in Greek staphyle means bunch of grapes and coccos means granule) is a genus of Gram-positive bacteria. ... “Surgeon” redirects here. ... Athletes foot or Tinea pedis[1] is a parasitic fungal infection of the epidermis of the foot. ... Xeroderma literally means dry skin. It is a condition involving the integumentary system, which in most cases can safely be treated with emollients and/or moisturizers. ... For the beetle, see Exema. ... Boil or furuncle is a skin disease caused by the inflammation of hair follicles, thus resulting in the localized accumulation of pus and dead tissues. ...

The appearance of the skin will help a doctor make a diagnosis. The doctor may also suggest blood tests, a wound culture or other tests to help rule out a blood clot deep in the veins of the legs. Cellulitis in the lower leg is characterized by signs and symptoms that may be similar to those of a clot occurring deep in the veins, such as warmth, pain and swelling.

This reddened skin or rash may signal a deeper, more serious infection of the inner layers of skin. Once below the skin, the bacteria can spread rapidly, entering the lymph nodes and the bloodstream and spreading throughout the body.

In rare cases, the infection can spread to the deep layer of tissue called the fascial lining. Necrotizing fasciitis, also called by the media "flesh-eating bacteria", is an example of a deep-layer infection. It represents an extreme medical emergency. Necrotizing fasciitis or fasciitis necroticans, commonly known as flesh-eating bacteria, is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue. ... {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ...

Infected left shin in comparison to shin with no sign of symptoms

Image File history File linksMetadata Size of this preview: 800 × 600 pixel Image in higher resolution (1632 × 1224 pixel, file size: 283 KB, MIME type: image/jpeg) Cellulitis case, my left knee infected. ... Image File history File linksMetadata Size of this preview: 800 × 600 pixel Image in higher resolution (1632 × 1224 pixel, file size: 283 KB, MIME type: image/jpeg) Cellulitis case, my left knee infected. ...

Risk factors

The elderly and those with weakened immune systems are especially vulnerable to contracting cellulitis. Diabetics are more susceptible to cellulitis than the general population because of impairment of the immune system; they are especially prone to cellulitis in the feet because the disease causes impairment of blood circulation in the legs leading to foot ulcers that commonly become infected. Old age consists of ages nearing the average lifespan of human beings, and thus the end of the human life cycle. ... In medicine, immune deficiency (or immunodeficiency) is a state where the immune system is incapable of defending the organism from infectious disease. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... Diabetic foot is an umbrella term for foot problems in patients with diabetes mellitus. ...

Immunosuppressive drugs, HIV, and other illnesses or infections that weaken the immune system are also factors that make infection more likely. In addition, chickenpox and shingles often result in blisters which break, providing a gap in the skin through which bacteria can enter. Lymphedema, which causes swelling on the arms and/or legs, can also put an individual at risk. For a list of immunosuppressive drugs, see the transplant rejection page. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... Chickenpox is the common name for Varicella zoster, classically one of the childhood infectious diseases caught by and survived by almost every child. ... Herpes zoster, colloquially known as shingles, is the reactivation of varicella zoster virus, leading to a crop of painful blisters over the area of a dermatome. ... Azskeptic 17:34, 10 July 2007 (UTC) Lymphedema, also spelled lymphoedema, also known as lymphatic obstruction, is a condition of localized fluid retention caused by a compromised lymphatic system. ...

Diseases that affect blood circulation in the legs and feet, such as chronic venous insufficiency and varicose veins, are also risk factors for cellulitis. Varicose veins are veins on the leg which are large, twisted, and ropelike, and can cause pain, swelling, or itching. ...

Cellulitis is also extremely prevalent amongst dense populations sharing hygiene facilities and common living quarters. Military installations which require communal showers provide such an environment, as it is prevalent among many recruits going through boot camp. Boot Camp is a software assistant made available by Apple Inc. ...

Diagnosis

Cellulitis is most often a clinical diagnosis, and local cultures do not always identify the causative organism. Blood cultures usually are positive only if the patient develops generalised sepsis. Conditions that may resemble cellulitis include deep vein thrombosis, which can be diagnosed with a compression leg ultrasound, and stasis dermatitis, which is inflammation of the skin from poor blood flow. blood culture Blood culture is microbiological culture of blood. ... Sepsis (in Greek Σήψις, putrefaction) is a serious medical condition, resulting from the immune response to a severe infection. ... This article is about Deep-vein thrombosis. ... Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structures and possible pathologies or lesions. ... Stasis dermatitis refers to the skin changes that occur in the leg as a result of stasis or blood pooling from insufficient venous return. ...

Incubation

Cellulitis can develop in as little as twenty-four hours or can take days to develop.

Duration

In many cases, cellulitis takes less than a week to disappear with antibiotic therapy. However, it can take months to resolve completely in more serious cases, and can result in severe debility or even death if untreated. If it is not properly cured it may appear to improve but can resurface again even after months and years.

Treatment

Antibiotics - typically a combination of intravenous and oral antibiotics are administered. Bed rest and elevation of affected limbs is also recommended. Often physicians suggest patients drink plenty of fluids as well.

Prevention

Good hygiene and good wound care lower the risk of cellulitis. Any wounds should be cleaned and dressed appropriately. Changing bandages daily or when they become wet or dirty will reduce the risk of contracting cellulitis. Medical advice should be sought for any wounds which are deep, dirty or if there is concern about retained foreign bodies.

Cellulitis in horses

Horses may acquire cellulitis, usually secondary to wound (which can be extremely small and superficial) or to a deep-tissue infection, such as an abscess or infected bone, tendon sheath, or joint. Cellulitis from a superficial wound will usually create less lameness (grade 1-2 out of 5) than that caused by septic arthritis (grade 4-5 lameness). The horse will exhibit inflammatory edema, producing a hot, painful swelling. this swelling differs from stocking up in that the horse will not display symmetrical swelling in 2 or four legs, but only in one leg.

This swelling begins near the source of infection, but will eventually continue downward the leg. In some cases, the swelling will also travel upward. Treatment includes cleaning the wound and caring for it properly, the administration of NSAIDs, such as phenylbutazone, cold hosing, applying a sweat wrap or a poultice, and mild exercise. Veterinarians may also perscribe antibiotics. Recovery is usually quick and the prognosis is very good if the cellulitis is secondary to skin infection. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Phenylbutazone, often known as bute, is a crystalline substance having the structure shown at right. ... A poultice is a soft moist mass, often heated and medicated, that is spread on cloth over the skin to treat an aching, inflamed, or painful part of the body. ... Staphylococcus aureus - Antibiotics test plate. ...

References

• King, Christine, BVSc, MACVSc, and Mansmann, Richard, VDM, PhD. "Equine Lameness." Equine Research, Inc. 1997. Pages 548-549.
• MFMER. 'Cellulitis'. 3 July 2002. Mayo Foundation for Medical Education and Research. 30 Oct. 2003 [1].
• NLM. 'Group A streptococcal infections'. 2002. National Library of Medicine. 30 Oct. 2003 > .
• Pankey, George A. "Approach to rashes and infections of the skin and subcutaneous tissues." Textbook of internal medicine. 2nd ed. 2 vols. Philadelphia: J. B. Lippincott Company, 1992.
• Cellulitis Overview (with picture).