Cellulitis

Question 1

What is cellulitis?

Answer 1

Cellulitis is an infection of the dermis (the deeper layer of the skin). The more superficial form of this infection is called erysipelas.

Question 2

Which layers of the skin are affected in cellulitis and erysipelas?

Answer 2

Cellulitis: Dermis and subcutaneous tissue

Erysipelas: More superficial layer of the dermis

Question 3

What are the primary causative organisms of cellulitis?

Answer 3

The main causative agent is β-haemolytic Streptococcus pyogenes, and less commonly Staphylococcus aureus.

Question 4

Name five risk factors for developing cellulitis.

Answer 4

Disruption of the skin barrier

Neglected wounds

Toe web intertrigo

Leg ulcers

Obesity

Question 5

What are the key clinical features of cellulitis?

Answer 5

Erythematous, hot, tender, oedematous patch

May have systemic symptoms: malaise, fever, nausea, vomiting

Can be bullous or haemorrhagic

Question 6

Which parts of the body are most commonly affected by cellulitis?

Answer 6

The lower leg is most commonly affected, but it can also occur on the face or other areas.

Question 7

What systemic symptoms can accompany cellulitis?

Answer 7

Systemic symptoms may include fever, malaise, nausea, and vomiting.

Question 8

What are four possible complications of cellulitis?

Answer 8

Recurrent infections leading to lymphoedema

Necrotizing fasciitis

Phlebitis

Osteomyelitis

Question 10

How can recurrent cellulitis lead to lymphoedema?

Answer 10

Repeated infections cause damage to lymphatic vessels, resulting in chronic lymphatic obstruction and persistent swelling.

Question 11

What is the first-line treatment for severe cellulitis?

Answer 11

Intravenous antibiotics, typically penicillin, are used for severe cases.

Question 12

How should mild cellulitis be treated?

Answer 12

Mild cellulitis can be treated with oral co-amoxyclav or clindamycin.

Question 13

What is the recommended management for recurrent cellulitis?

Answer 13

For recurrent cases, monthly benzathine penicillin (1.2–2.4 million units intramuscularly) can be given as prophylaxis.