Cellulitis

Question 1

What is Cellulitis?

Answer 1

• Cellulitis is a bacterial infection that affects the dermis and deeper subcutaneous tissues

Question 2

What are the organisms which cause Cellulitis?

Answer 2

• Streptococcus Pyogenes
• Staphylococcus Aureus

Question 3

What are the clinical features of Cellulitis?

Answer 3

• Commonly occur on the shins
• Usually unilateral
• Erythema - well-defined margins, blister and bullae (indicate more severe disease)
• Swelling
• Systemic Upset (Fever, Malaise, Nausea)

Question 4

How do you make a diagnosis of Cellulitis?

Answer 4

• A diagnosis of Cellulitis is Clinical
• Blood and Blood Cultures - if sepsis suspected

Question 5

What is the Classification for Cellulitis ?

Answer 5

• Eron Classification

Question 6

What is stage 1 of Eron Classification?

Answer 6

• There are no signs of systemic toxicity and the person has no uncontrolled co-morbidities

Question 7

What is stage 2 of Eron Classification?

Answer 7

• The person is either systemically unwell
  OR
• Systemically well with a co-morbidity (PAD, CVI, Morbid Obesity)

Question 8

What is stage 3 of Eron Classification?

Answer 8

• The person has signifiant systemic upset (acute confusion, tachycardia, tachypnoea, hypotension or unstable co-morbidities that interfere with a response to treatment)

Question 9

What is Stage 4 of Eron Classification?

Answer 9

• The person has sepsis syndrome
  OR
• A severe life-threatening infection such as NEC fasciitis

Question 10

When do you recommend admitting the patient for IV Abx?

Answer 10

• Eron Class 3 or 4 cellulitis
• Has severe or rapidly deteriorating cellulitis
• Is very young or frail
• Is immunocompromised
• Significant lymphoedema
• Has facial cellulitis or periorbital cellulitis

Question 11

What is the Managment for Eron Class 1 and 2?

Answer 11

• oral antibiotics
• oral Flucloxacillin, for first line treatment
• Oral Clarithromycin (for penicillin allergy)
• Oral Erythromycin ( in pregnancy)

Question 12

What is the managment for Eron Class 2?

Answer 12

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