Often in clinical practice, doctors encounter patients who complain of their legs being swollen. While there are a number of reasons why this might be the case, one possible cause is a condition called cellulitis.
Cellulitis is not a condition to be ignored. This is because it can lead to a number of complications if the right treatment is not given at the right time.
Today, we shall take a look at what cellulitis is, how it is diagnosed, who is at risk of developing this problem, and what steps can be taken to prevent it.
Our skin is the largest organ in our body. It consists of a number of layers, each with a function of their own.
The surface of the skin that we are able to touch and see is called the epidermis. Right below this is a layer of cells that is called the dermis. The dermis contains hair follicles and sweat glands along with blood vessels.
Beneath this layer is the subcutaneous tissue, which contains fat cells.
The skin and the tissues underlying it have a role of protecting the structures beneath it. Any damage to the skin can be a portal for bacteria to enter the tissues underneath and cause infections.
It is for this very reason that all care must be taken to keep the skin healthy, soft and supple.
What Is Cellulitis?
In the simplest of terms, cellulitis is a skin infection. It is a bacterial infection of the skin and the tissues that are present right below it. It extends all the way from the epidermis to the subcutaneous tissues.
It is a common condition that is often seen by doctors in practice. Fortunately, it is easily identifiable and can be treated effectively with antibiotics. However, a delay in treatment can lead to complications which can be harder to treat.
What Causes Cellulitis?
Cellulitis is caused by bacteria. These bacteria usually enter the skin through a break in the skin or following an injury.
The common bacteria that cause cellulitis include Streptococcus and Staphylococcus. Other organisms include Hemophilus influenza and Clostridium (you are welcome to try and remember these names, but they can be quite confusing! It is best to remember that cellulitis is a bacterial infection).
What The Risk Factors For Cellulitis?
Cellulitis can occur in literally anyone. There is no specific age group in which it is predominant in though the trend appears to be increased in elderly individuals.
Some of the common risk factors in the development of cellulitis include –
- Injury to the skin – If you have fallen and scraped your skin or have suffered a cut or a bruise, the bacteria can enter the skin and cause cellulitis.
- Skin conditions such as eczema and chickenpox increase the risk of bacterial entry into the subcutaneous tissues leading to the formation of cellulitis.
- A poor immune system seen in conditions such as diabetes, leukaemia and HIV can lower the resistance of the body to fight simple bacterial infections. So, when the bacteria enter the skin, the body is unable to fight it and cellulitis sets in.
- Certain medications such as long-term use of steroid tablets can also increase the risk of cellulitis.
- Being overweight or obese is a common risk factor in the development of cellulitis. This has partly to do with how well the blood flows throughout the body.
- If an individual has suffered from cellulitis in the past, there is always an increased risk of developing the same problem in the future.
- Diabetes mellitus is an extremely common reason for the development of cellulitis. Diabetes can cause cracks in the skin, especially in between the toes. Improper foot hygiene can ultimately lead to entry of bacteria through these cracks into the subcutaneous tissues. The excess sugar in the bloodstream that is seen in diabetes mellitus can act as an excellent food source for bacteria, causing them to thrive underneath the skin. This leads to cellulitis.
What Are The Symptoms Of Cellulitis?
Firstly, cellulitis can occur in any part of the body. This includes the hands, face and legs. However, cellulitis often affects the lower limbs.
The primary symptom of cellulitis is swelling and redness in the area of infection. The infected area is warm and tender to touch. As there is a bacterial infection present, the patient will usually have a fever as well. If cellulitis affects the lower limbs, there may be difficulty walking. If it affects the upper limbs, there may be difficulty performing day-to-day tasks with the hands.
Sometimes, cellulitis can extend deeper through the subcutaneous tissue all the way to the bone. This makes it an extremely painful condition.
If you notice any swelling and redness in any part of the body and are having a fever, make sure you see your doctor straight away.
How Is Cellulitis Diagnosed?
The best way to diagnose cellulitis is through clinical examination. The history and clinical findings are usually characteristic and make the diagnosis of cellulitis quite easy.
In order to confirm cellulitis, certain tests may be required.
Blood tests to determine the level of white cells in the bloodstream can point towards a bacterial infection. White blood cells of the body’s defence against infections and increasing number the presence of a bacterial infection.
An ultrasound scan of the affected area can help confirm the presence of infection and fluid in the affected area. If the individual has a high fever, a blood culture test can help find out which organism is causing the infection.
Other blood tests include checking blood sugar levels to see if diabetes mellitus is under control or to make a diagnosis of diabetes.
Treatment Of Cellulitis:
The best way to treat cellulitis is through oral antibiotics. Depending on the severity, one or more antibiotics may be prescribed by the doctor. The duration of treatment varies on the extent that cellulitis of affected the area. Treatments may range anywhere between five days up to 2 to 3 weeks.
In some patients, oral antibiotics are ineffective. In such individuals, admission to hospital and intravenous antibiotics may be necessary.
If cellulitis does not respond despite antibiotics and a large collection of infection persists under the skin, a surgical opinion may be sought after. The surgeon will make small incisions on the skin to drain out any infection that may be present under it. Draining the infection can speed up the recovery process.
Complications Of Cellulitis:
If cellulitis is not treated soon, it can lead to spread of the bacterial infection into the bloodstream. This is known as sepsis and is a serious problem. Sepsis can lead to a high heart rate and low blood pressure and can damage organs such as the liver and the kidney.
In rare cases, the cellulitis can extend deeper into the subcutaneous tissues all the way to the bone. This deep infection is sometimes called necrotising fasciitis and is caused by streptococcal infections. It is a medical emergency that requires surgical treatment as soon as possible.
How Can Cellulitis Be Prevented?
The best way to prevent cellulitis is to maintain good skin hygiene. If you normally suffer from dry skin, make sure you keep it clean by washing it regularly with soap and water and applying a good quality moisturiser.
If you have suffered a skin wound, wash it with soap and water and apply a prescribed antibiotic ointment. The may need covering to protect it from dust.
Always examine the skin wound regularly to ensure that an infection has not set in. Warning signs include redness, swelling and pain.
If you suffer from diabetes, it is extremely important that you maintain excellent foot hygiene. Make sure you wear footwear at all times, especially when you venture out of the house. This will prevent any stray thorns or sticks from causing injury to your skin.
Inspect the gaps in between your toes every day. After you have washed your feet, dry the skin in between the toes. Keep your toenails trimmed.
Cellulitis is a common skin problem that can be treated effectively if it is diagnosed early. There are a number of different risk factors that can lead to the problem, and simple preventative measures can avoid it from becoming serious.