Cellulitis
Summary
This is a brief article sharing some important information on cellulitis.
Basics
This is a superficial skin infection caused by bacteria. It may present as an acute or chronic infection. The infection is caused by streptococci and staphylococci. The infection is characterized by:
1. Oedema
2. Redness
3. Increased local temperature
4. NO suppuration (No pus)
The infection is commonly associated with lymphangitis and there may/may not be regional lymph node involvement.
Management
General
- Elevate the limb in order to reduce swelling and discomfort.
Medical
- Children > 7 years old and adults.
- Cefalexin 500mg PO 6 hourly for 5 days or Flucloxacillin 500mg PO 6 hourly for 5 days.
- Children ≤ 7 years old.
- Cefalexin 12-25mg/kg/dose PO 6 hourly for 5 days or Flucloxacillin 12-25mg/kg/dose PO 6 hourly for 5 days.
If the patient has a severe penicillin allergy, you may use a macrolide such as azithromycin 500mg ( or 10mg/kg/dose) PO OD for 3 days.
Referral
Urgent
- Severe disease, to exclude osteomyelitis
- Gangrene
- Extensive cellulitis
- Recurrent cellulitis is associated with underlying conditions such as lymphoedema.
- Cellulitis with systemic manifestations such as hypotension, altered mental status, tachycardia, fever
- Cellulitis in patients with poorly controlled diabetes
- Involvement of certain body parts, for instance, the hand, face, and scalp.
Non-urgent
- Inadequate response to the initial antibiotics
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