Cellulitis causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Cellulitis Microchapters
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Overview

Group A streptococcus and staphylococcus are the most common causative agents of cellulitis. These bacteria are part of the normal flora living on the skin.

Causes

• The causative pathogen of cellulitis varies with the anatomical location and the patient’s medical and exposure history.

Predisposing factor, anatomical location, and likely etiology of cellulitis

Predisposing Factor	Anatomical Location	Likely Etiology
Periorbital (preseptal) cellulitis	Eyelid and periocular tissues	Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes
Buccal cellulitis in children without Hib vaccine	Cheek	Haemophilus influenzae
Cellulitis complicated by body piercing	Ear, nose, umbilicus	S. aureus, S. pyogenes
Perianal cellulitis	Perineum	S. pyogenes
Subcutaneous injection of illicit drugs (“skin popping”)	Extremities, neck	S. aureus, Streptococcus (group A, C, F, G)
Breast surgert with axillary lymph-node dissection	Ipsilateral arm	Non–group A hemolytic Streptococcus
Harvest of saphenous vein	Ipsilateral leg	Group A or non–group A hemolytic Streptococcus
Crepitant or gangrenous cellulitis	Extremities, Trunk	Clostridium or non–spore-forming anaerobes; alone or with E. coli, Klebsiella, or Aeromonas
Diabetic foot ulcer	Dorsum of foot or toes	Aerobic gram-negative bacilli (Enterobacteriaceae, P. aeruginosa, Acinetobacter) or anaerobes
Exposure to salt water at breeches of skin	Extremities	Vibrio vulnificus
Exposure to fresh water at breeches of skin	Extremities	Aeromonas hydrophila
Medicinal leech therapy	Extremities	Aeromonas hydrophila
Working as a butcher, fish or clam handler, veterinarian	Fingers	Erysipelothrix rhusiopathiae