Cellulitis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-In-Chief: Aditya Govindavarjhulla, M.B.B.S.

Overview

Cellulitis results in activation of the body's inflammatory response mechanisms. When the immune system cannot respond adequately, it can spread systemically through the blood stream.

Natural history

Cuts and wounds on the skin are the most common means of contracting cellulitis. Other conditions may also lead to the condition. Staphylococcus aureus and Group A Streptococci are the most common causative microbes of the infection. When the bacteria invades the skin, they release toxins which cause local erythema, pain, and induration. With a course of oral antibiotics it resolves. Cellulitis spreads fairly fast with no treatment and can lead to multiple complications which can be very serious threat.

Complications

Cellulitis can be complicated by the development of:

• Blood infection (sepsis)
• Bone infection (osteomyelitis)
• Inflammation of the lymph vessels (lymphangitis)
• Inflammation of the heart (endocarditis)
• Meningitis
• Shock
• Tissue death (gangrene)

Prognosis

Cellulitis is not a self limiting condition. It has to be treated with antibiotics. Treatment with oral antibiotics for a period of week or 10 days usually resolves the infection. In immunodeficient individuals it takes time to heal and may not be resolved completely at times. Long course of antibiotics are needed in few. In few untreated or resistant cases it may lead to further complications. Some people are prone for recurrent infections at the same site which may lead to permanent skin changes. In few complicated gangrenes may cause loss of limb even.