Cellulitis

Cellulitis 

Cellulitis is a common bacterial skin infection that can be important and serious at times. The affected skin is irritated , swollen, warm, and painful to the touch. 

Cellulitis is a superficial skin infection usually, but in some severe cases or if left untreated  it can spread to the lymph nodes or bloodstream and become life-threatening quickly, so it is important to treat it appropriately.

Cellulitis commonly affects the lower limbs, but it can occur on the face, arms, around the eyes, breasts, and other parts of the body.

This inflammation generally occurs due to a skin injury with entry point that allows bacteria to enter.

 This infection is not contagious, and the only way for it to spread from person to person is by direct contact between open wounds.

Causes:

Cellulitis occurs when bacteria enter the skin through an entry point such as inflamed and unclean wounds, ulcers, insect bites, burns, surgical wounds, or foreign objects in the skin. 

Staphylococcus and Streptococcus bacteria are considered the most important organisms causing these types of infections as they commonly live on the skin surface and around the nails.

The incidence of a more serious staphylococcus infection called methicillin-resistant Staphylococcus aureus (MRSA) is increasing.

Symptoms:

1. Irritated area of the skin that tends to expand and spread. 

2. Swelling and redness. 

3. Pain when touching the affected area. 

4. Warm skin. 

5. Rash, blisters, and pustules. 

6. Skin dimpling. 

7. Pus or yellowish fluid draining from the affected area. 

8. Fever and chills.

Risk factors:

1. Skin injuries:

 Any wound, ulcer, burn, or insect bite is a suitable entry point for bacteria to enter the skin. 

2. Weakened immune system: Certain medical conditions that weaken the immune system such as diabetes, leukemia, and AIDS, as well as certain medications that weaken the immune system. 

3. Skin disorders: Some skin conditions such as atopic dermatitis, eczema, athlete's foot, and psoriasis can cause skin injuries that allow bacteria to enter. 

4. Liver infections and cirrhosis. 

5. Lymphatic edema. 

6. Previous history of cellulitis. 

7. Obesity.

Complications:

1. Bacteremia 

2. Toxic shock syndrome. 

3. endocarditis

4. Osteomyelitis. 

5. Suppurative arthritis. 

6. Necrotizing fasciitis, which is a emergency condition that occurs when the infection reaches the deep layers of tissues. 

7. Chronic swelling due to lymphatic vessel damage in the affected limb.

Diagnosis:

Diagnosis is made by the doctor based on the appearance of the skin, examination, and questioning about accompanying symptoms. The examining doctor may request blood tests or X-rays to rule out foreign bodies or bone injuries, as well as perform a bacterial culture by taking a sample of the purulent fluid present at the site of inflammation.

Treatment:

Antibiotics are the cornerstone of cellulitis treatment and should be taken under the supervision of the treating doctor for a duration of at least 7 to 14 days.

 Hospitalization and intravenous antibiotics may be required in cases where the infection does not improve within a few days of oral antibiotics, when the infection covers a large area of the body, when there is immune deficiency, or when the infection is around the eye.

 Surgery may be necessary if there is an abscess or a collection of pus in the tissues, where it is removed along with the necrotic tissues. Warm compresses may also be recommended for the affected areas.

Prevention:

Doctors may advise taking preventive antibiotics if there is a recurrence of skin injuries leading to repeated episodes of cellulitis . In addition, the following measures should be taken when suffering from a skin wound: 

1. Wash the wound daily,if recommended by the doctor, with water and soap and do this gently 

2. Use a protective cream or ointment on the wound, such as vaseline or polysporin. Many of them can be purchased without a prescription. 

3. Cover the wound with a bandage and change it daily.

Special recommendations for prevention in patients with diabetes and peripheral vascular disease:

1. Daily foot examination to look for any skin injury and promptly treat it. 

2. Trim nails with caution and take care not to injure the surrounding skin. 

3. Protect the feet and hands by wearing appropriate footwear and gloves for different activities. 

4. Properly treat skin injuries, athlete's foot, and fungal infections. 

5. Keep the skin moisturized to prevent dryness and peeling, avoiding the use of moisturizers on open wounds.