Cellulitis

Invasion of the dermis and subcutaneous fat - deeper skin infection

Aetiology

  • Causative organisms: Strep. pyogenes +/- Staph. aureus
  • More common in diabetics

Clinical presentation

  • Generalised swelling usually seen in the legs
  • Macular hot erythema with ill defined margins that is often spreading
  • Fevers, rigours and nausea
notion image

Investigations

  • Usually clinical diagnosis
  • If there is an atypical presentation, the patient is very unwell or there is failure to respond to treatment, cultures from possible portals of entry may be valuable
  • Blood culture and swabs and culture of any blister fluid may also be helpful, usually in those patients where the diagnosis is in doubt

Management

General

  • Rest
  • Elevation
  • Analgesia
  • Splint

Antibiotics

  • 1st line: 0.5 - 1g Flucloxacillin QDS, 7/7 (alternative: doxycycline 100mg BD, 7/7)
  • Severe: IV flucloxacillin (vancomycin if allergic)