Cellulitis and Erysipelas
exp date isn't null, but text field is
Cellulitis is an acute inflammation of the skin involving the dermis and subcutaneous tissues, caused mainly by streptococci and staphylococci. Erysipelas has a raised demarcated border, where as the border is not distinct in cellulitis.
Cause
- Streptococcus and S.Aureus in adults
- Haemophilus influenza type b in children under 3 years
- Cellulitis is sometimes caused by other organisms
Predisposing Factors
- Minor trauma
- Pre-existing lesion such as ulcer or erosion
Clinical features
- Erythema (reddening)
- Pain, tenderness
- Acute localised swelling and oedema
- In erysipelas, lesions are more superficial and have a defined raised margin
- Skin becomes tense and shiny in advanced stages
- Regional lymphadenitis may be present
Differential diagnosis
- Lymphoedema
- Acute osteomyelitis
- Deep vein thrombosis (DVT)
- Blunt trauma/fracture
Investigations
- Pus swab for Gram staining and culture and sensitivity
ManagementTreatment
- Elevate the affected limb
- Give an analgesic e.g. paracetamol 1 g every 6-8 hours as required, Child: 10 mg/kg
- Antibiotics: cloxacillin 250-500 mg every 6 hours before food for 7 days
- Child: 12.5-25 mg/kg per dose
- OR in penicillin allergy, erythromycin 500 mg every 6 hours
- Child: 7.5 mg/kg per dose
If severe
- IV ceftriaxone
- Adult: 1 g every 12 hours for 3 days
- Child: 50 mg/kg
- Then oral antibiotics to complete 1 week of antibiotics