6.4 Cellulitis

Question 1

red flags

Answer 1

• Signs of shock.
• Severe pain, oedema or blistering.
• Skin necrosis.
• Inability to mobilise.
• Rigors.
• Neutropenia.
• Chemotherapy within the last four weeks.
• Temperature > 40°C.
• An associated abscess.
• Involves > 5% of body surface area.
• Rapidly spreading.
• Involves the face, hands or genitals.
• Diabetes on insulin.
• Significant lymphangitis.
• A hot or painful joint.
• Associated with a bite wound.
• Frail, elderly or significant comorbidities.
• New onset of an altered mental status.

Question 2

A hot or painful joint indicates the possibility of

Answer 2

septic arthritis

Question 3

Provide advice if the patient is not being transported to a medical facility:

Answer 3

ū Keep the limb elevated if possible.
ū Take paracetamol and/or ibuprofen for analgesia.
ū Call an ambulance if signs of severe systemic illness (for example feeling
faint, severe nausea, severe vomiting or rigors) develop or the patient becomes unable to mobilise.