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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| {{Infobox_Disease | | | {{Infobox_Disease | |
| Name = {{PAGENAME}} | | | Name = {{PAGENAME}} | |
| Image = Cellulitis3.JPG | | | Image = Cellulitis3.JPG | |
| Caption = Infected left shin | | | Caption = Infected left shin | |
| DiseasesDB = 29806 |
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| ICD10 = {{ICD10|L|03||l|00}} |
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| ICD9 = {{ICD9|682.9}} |
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| MeshID = D002481 |
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| {{Cellulitis}} | | {{Cellulitis}} |
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| | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| | {{CMG}}; {{AE}} [[User:Aditya Govindavarjhulla|Aditya Govindvarjhulla, M.B.B.S.]], {{NE}} |
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| ==[[Cellulitis overview|Overview]]== | | ==[[Cellulitis overview|Overview]]== |
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| ==[[Cellulitis historical perspective|Historical Perspective]]== | | ==[[Cellulitis historical perspective|Historical Perspective]]== |
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| | ==[[Cellulitis classification|Classification]]== |
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| ==[[Cellulitis pathophysiology|Pathophysiology]]== | | ==[[Cellulitis pathophysiology|Pathophysiology]]== |
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| ==[[Cellulitis epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Cellulitis risk factors|Risk Factors]]==
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| ==[[Cellulitis screening|Screening]]==
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| ==[[Cellulitis causes|Causes]]== | | ==[[Cellulitis causes|Causes]]== |
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| ==[[Cellulitis differential diagnosis|Differentiating Cellulitis]]== | | ==[[Cellulitis differential diagnosis|Differentiating Cellulitis from other Diseases]]== |
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| ==[[Cellulitis natural history|Complications & Prognosis]]== | | ==[[Cellulitis epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Diagnosis== | | ==[[Cellulitis risk factors|Risk Factors]]== |
| [[Cellulitis history and symptoms|History and Symptoms]] | [[Cellulitis physical examination|Physical Examination]] | [[Cellulitis staging|Staging]] | [[Cellulitis laboratory tests|Laboratory tests]] | [[Cellulitis electrocardiogram|Electrocardiogram]] | [[Cellulitis x ray|X Rays]] | [[Cellulitis CT|CT]] | [[Cellulitis MRI|MRI]] [[Cellulitis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Cellulitis other imaging findings|Other images]] | [[Cellulitis other diagnostic studies|Alternative diagnostics]] | |
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| ==Treatment== | |
| [[Cellulitis medical therapy|Medical therapy]] | [[Cellulitis surgery|Surgical options]] | [[Cellulitis primary prevention|Primary prevention]] | [[Cellulitis secondary prevention|Secondary prevention]] | [[Cellulitis cost-effectiveness of therapy|Financial costs]] | [[Cellulitis future or investigational therapies|Future therapies]]
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| ==Causes==
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| Cellulitis is caused by a type of [[bacterium|bacteria]] entering by way of a break in the skin. This break need not be visible. [[Group A streptococcal infection|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]], [[xeroderma|dry skin]], [[eczema]], burns and [[boil]]s, though there is debate as to whether minor foot lesions contribute.
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| 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.
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| 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.
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| 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]].
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| [[Image:Cellulitis1.JPG|thumb|left|Infected left shin in comparison to shin with no sign of symptoms]]
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| ==Risk factors==
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| The [[elderly]] and those with [[Immunodeficiency|weakened immune systems]] are especially vulnerable to contracting cellulitis. [[diabetes mellitus|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 their disease causes impairment of blood circulation in their legs leading to their having [[Diabetic foot|foot ulcers]] that commonly become infected. Cellulitis is also a common complication of [[obesity]].
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| [[Immunosuppressive drug]]s, [[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.
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| Diseases that affect blood circulation in the legs and feet, such as chronic venous insufficiency and [[varicose vein]]s, are also risk factors for cellulitis.
| | ==[[Cellulitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| 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.
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| ==Diagnosis== | | ==Diagnosis== |
| Cellulitis is most often a clinical diagnosis, and local cultures do not always identify the causative organism. [[Blood culture]]s 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 [[medical ultrasonography|ultrasound]], and [[stasis dermatitis]], which is inflammation of the skin from poor blood flow.
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| ==Incubation==
| | [[Cellulitis diagnostic study of choice|Diagnostic study of choice]] | [[Cellulitis history and symptoms|History and Symptoms]] | [[Cellulitis physical examination|Physical Examination]] | [[Cellulitis laboratory tests|Laboratory Findings]] | [[Cellulitis chest x ray|Chest X Ray]] | [[Cellulitis CT|CT]] | [[Cellulitis MRI|MRI]] | [[Cellulitis ultrasound|Ultrasound]] | [[Cellulitis other diagnostic studies|Other Diagnostic Studies]] |
| Cellulitis can develop in as little as twenty-four hours or can take days to develop. | |
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| ==Duration==
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| 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.
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| ==Treatment== | | ==Treatment== |
| | [[Cellulitis medical therapy|Medical Therapy]] | [[Cellulitis surgery|Surgery]] | [[Cellulitis primary prevention|Primary Prevention]] | [[Cellulitis secondary prevention|Secondary Prevention]] | [[Cellulitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Cellulitis future or investigational therapies|Future or Investigational Therapies]] |
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| Antibiotics - typically a combination of intravenous and oral antibiotics are administered. Bed rest and elevation of affected limbs is also recommended. Drink plenty of fluids as well - at least 8 glasses of water a day.
| | ==Case Studies== |
| | [[Cellulitis case study one|Case #1]] |
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| ==Prevention==
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| 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.
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| ==Cellulitis in horses==
| | {{Diseases of the skin and subcutaneous tissue}} |
| 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.
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| 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 [[NSAID]]s, such as [[phenylbutazone]], cold hosing, applying a sweat wrap or a [[poultice]], and mild exercise. Veterinarians may also perscribe [[antibiotic]]s. Recovery is usually quick and the prognosis is very good if the cellulitis is secondary to skin infection.
| | [[Category:Disease]] |
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| ==References==
| | [[Category:Dermatology]] |
| *King, Christine, BVSc, MACVSc, and Mansmann, Richard, VDM, PhD. "Equine Lameness." Equine Research, Inc. 1997. Pages 548-549.
| | [[Category:Emergency medicine]] |
| *MFMER. 'Cellulitis'. 3 July 2002. Mayo Foundation for Medical Education and Research. 30 Oct. 2003 [http://www.mayoclinic.com/invoke.cfm?id=DS00450&dsection=1].
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| *NLM. 'Group A streptococcal infections'. 2002. National Library of Medicine. 30 Oct. 2003 [http://www.niaid.nih.gov/factsheets/strep.htm>].
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| *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.
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| *[http://www.healthinplainenglish.com/health/skin/cellulitis/index.htm Cellulitis Overview] (with picture).
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| {{Diseases of the skin and subcutaneous tissue}}
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| [[Category:Bacterial diseases]] | | [[Category:Bacterial diseases]] |
| [[Category:Diseases involving the fasciae]] | | [[Category:Diseases involving the fasciae]] |
| [[Category:Inflammations]] | | [[Category:Inflammations]] |
| [[Category:Dermatology]]
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| [[Category:Overview complete]]
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