http://webcache.googleusercontent.com/search?

q=cache:83V4fgCDjMMJ:en.wikipedia.org/wiki/Cellulitis+cellulitis&cd=1&hl=id&ct=c
lnk&gl=id&source=www.google.co.id
Cellulitis
From Wikipedia, the free encyclopedia
Jump to: navigation, search
This article is about infection of skin and its underlying connective tissue. For the
dimpled appearance of skin, see cellulite.

Cellulitis
Classification and external resources

Infected left shin

ICD-10

L03.

ICD-9

682.9

DiseasesDB 29806
eMedicine

med/310 emerg/88 derm/464

MeSH

D002481

Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of

dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin
flora or by exogenous bacteria, and often occurs where the skin has previously been

broken: cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, illegal
drug injection or sites of intravenous catheter insertion. Skin on the face or lower
legs is most commonly affected by this infection, though cellulitis can occur on any
part of the body. The mainstay of therapy remains treatment with appropriate
antibiotics, and recovery periods last from 48 hours to six months.
Erysipelas is the term used for a more superficial infection of the dermis and upper
subcutaneous layer that presents clinically with a well-defined edge. Erysipelas and
cellulitis often coexist, so it is often difficult to make a distinction between the two.
Cellulitis is unrelated (except etymologically) to cellulite, a cosmetic condition
featuring dimpling of the skin.
Contents
[hide]

1 Signs and symptoms

2 Causes
o

2.1 Risk factors

3 Diagnosis

4 Treatment

5 In animals

6 See also

7 References

8 External links

[edit] Signs and symptoms

The typical symptoms of cellulitis is an area which is red, hot, and tender.

Cellulitis following an abrasion. Note the red streaking up the arm from involvement of
the lymphatic system.

Infected left shin in comparison to shin with no sign of symptoms

[edit] Causes

Cellulitis is caused by a type of bacteria entering the skin, usually by way of a cut, abrasion, or
break in the skin. This break does not need to be visible. Group A Streptococcus and
Staphylococcus are the most common of these bacteria, which are part of the normal flora of the
skin, but normally cause no actual infection while on the skin's outer surface.
Predisposing conditions for cellulitis include insect or spider bite, blistering, animal bite, tattoos,
pruritic (itchy) skin rash, recent surgery, athlete's foot, dry skin, eczema, injecting drugs
(especially subcutaneous or intramuscular injection or where an attempted IV injection "misses"
or blows the vein), pregnancy, diabetes and obesity, which can affect circulation, as well as burns
and boils, though there is debate as to whether minor foot lesions contribute.
Occurrences of cellulitis may also be associated with the rare condition hidradenitis suppurativa.
The photos shown here of cellulitis are of mild cases, and are not representative of earlier stages
of the disease. The appearance of the skin will assist a doctor in determining a diagnosis. A
doctor may also suggest blood tests, a wound culture or other tests to help rule out a blood clot
deep in the veins of the legs. Cellulitis in the lower leg is characterized by signs and symptoms
similar to those of a deep vein thrombosis, such as warmth, pain and swelling (inflammation).
This reddened skin or rash may signal a deeper, more serious infection of the inner layers of skin.
Once below the skin, the bacteria can spread rapidly, entering the lymph nodes and the
bloodstream and spreading throughout the body. This can result in influenza- like symptoms with
a high temperature and sweating or feeling very cold with shaking, as the sufferer cannot get
warm.
In rare cases, the infection can spread to the deep layer of tissue called the fascial lining.
Necrotizing fasciitis, also called by the media "flesh-eating bacteria", is an example of a deeplayer infection. It is a medical emergency.
[edit] Risk factors

The elderly and those with immunodeficiency (a weakened immune system) are especially
vulnerable to contracting cellulitis. Diabetics are more susceptible to cellulitis than the general

population because of impairment of the immune system; they are especially prone to cellulitis
in the feet, because the disease causes impairment of blood circulation in the legs, leading to
diabetic foot/foot ulcers. Poor control of blood glucose levels allows bacteria to grow more
rapidly in the affected tissue, and facilitates rapid progression if the infection enters the
bloodstream. Neural degeneration in diabetes means these ulcers may not be painful and thus
often become infected.
Immunosuppressive drugs, and other illnesses or infections that weaken the immune system are
also factors that make infection more likely. Chickenpox and shingles often result in blisters that
break open, providing a gap in the skin through which bacteria can enter. Lymphedema, which
causes swelling on the arms and/or legs, can also put an individual at risk.
Diseases that affect blood circulation in the legs and feet, such as chronic venous insufficiency
and varicose veins, are also risk factors for cellulitis.
Cellulitis is also extremely prevalent among dense populations sharing hygiene facilities and
common living quarters, such as military installations, college dormitories, nursing homes, oil
platforms and homeless shelters. It is advised if a cabin is shared with a sufferer, urgent medical
treatment should be given.
[edit] Diagnosis

Cellulitis is most often a clinical diagnosis, and local cultures do not always identify the
causative organism. Blood cultures usually are positive only if the patient develops generalized
sepsis. Conditions that may resemble cellulitis include deep vein thrombosis, which can be
diagnosed with a compression leg ultrasound, and stasis dermatitis, which is inflammation of the
skin from poor blood flow. Associated musculoskeletal findings are sometimes reported. When it
occurs with acne conglobata, hidradenitis suppurativa, and pilonidal cysts, the syndrome is
referred to as the follicular occlusion triad or tetrad.[2]
There have been many cases where Lyme disease has been misdiagnosed as staphylococcal- or
streptococcal-induced cellulitis. Because the characteristic bullseye rash does not always appear
in patients infected with Lyme disease, the similar set of symptoms may be misdiagnosed as
cellulitis. Standard treatments for cellulitis are not sufficient for curing Lyme disease. The only
way to rule out Lyme disease is with a blood test, which is recommended during warm months in
areas where the disease is endemic.[3]
[edit] Treatment

Treatment consists of resting the affected area, cutting away dead tissue, and antibiotics (either
oral or intravenous).[4] Flucloxacillin or dicloxacillin monotherapy (to cover staphylococcal
infection) is often sufficient in mild cellulitis, but in more moderate cases, or where

streptococcal infection is suspected, then this course is usually combined with oral
phenoxymethylpenicillin or intravenous benzylpenicillin, or ampicillin/amoxicillin (e.g. coamoxiclav in the UK). Pain relief is also often prescribed, but excessive pain should always be
investigated as it is a symptom of necrotising fasciitis.
As in other maladies characterized by wounds or tissue destruction, hyperbaric oxygen treatment
can be a valuable adjunctive therapy, but is not widely available.[5][6]
[edit] In animals

Horses may acquire cellulitis, usually secondary to a wound (which can be extremely small and
superficial) or to a deep-tissue infection, such as an abscess or infected bone, tendon sheath, or
joint.[7][8] Cellulitis from a superficial wound will usually create less lameness (grade 1-2 out of
5) than that caused by septic arthritis (grade 4-5 lameness). The horse will exhibit inflammatory
edema, which is marked by hot, painful swelling. This swelling differs from stocking up in that
the horse will not display symmetrical swelling in two or four legs, but in only one leg. This
swelling begins near the source of infection, but will eventually continue down the leg. In some
cases, the swelling will also travel upward. Treatment includes cleaning the wound and caring for
it properly, the administration of NSAIDs, such as phenylbutazone, cold hosing, applying a
sweat wrap or a poultice, and mild exercise. Veterinarians may also prescribe antibiotics.
Recovery is usually quick, and the prognosis is very good if the cellulitis is secondary to skin
infection.
[edit] See also

Haemophilus influenzae cellulitis

Vibrio vulnificus infection

Aeromonas infection

Helicobacter cellulitis

Tuberculous cellulitis

List of cutaneous condition