Cellulitis Infection

        Cellulitis infection is a reaction of local soft tissue swelling secondary to bacterial invasion in the skin. Classic symptoms of cellulitis were previously assigned to bacterial invasion and the subsequent proliferation of local tissue, however, there is evidence to suggest that most symptoms can actually follow a comprehensive set of immune and inflammatory reactions triggered by superficial cells.

Why is it cellulitis infectious?

       It can be classified as an infectious disease because it is determined by certain types of bacteria. The most common ones are streptococci and staphylococci. In children another cause may be the Haemophilus influenzae B (HiB), but nowadays cellulitis can be avoided by vaccinating your children. Cellulitis infection can also be recurrent, especially when the cause is a streptococcus. Most frequently, people with chronic lymphedema are exposed to this illness, but also those who inject themselves drugs are predisposed to cellulitis.

       Another uncommon cause of cellulitis infection is the S pneumoniae. The disease is in this case named Pneumococcal cellulitis and may appear because of bacteremia. The majority of patients were previously immunocompromised by different substances like alcohol or drugs or suffering from a chronic illness. In children, pneumococcal cellulitis appears primarily on the face.

Uncommon ways of contacting bacteria

       Above the usual ways of developing cellulitis, after a wound, cut, surgical procedure, there are also other possibilities. For example, for animal bites, the triggering bacterium is pasteurella multocida. The seawater contains Vibrio vulnificus and Chormobacterium violaceum while in the aquaculture farms, the one that causes infections like cellulitis is Streptococcus iniae. After a gunshot or after the patient has suffered many invasive procedures, Acinetobacter baumannii can cause this and many other infections of the soft tissue. Note that the pathogen is multidrug-resistant it is possible to contact it from a hospital.

Cellulitis infection pictures

Epidemiology

       It is assumed that cellulitis affects selectively the elderly, the immunocompromised and those people with peripheral vascular disease. Epidemiological data on prevalence and incidence were difficult to obtain and interpret. A study of 300,000 patients and over a year identified approximately 4,000 cases of cellulitis, or 1.3% of all patients who presented to the doctor. Characteristics of the patients showed a slight predominance in males (61%), an average age of 46 years, the vast majority of infections involving extremities either the upper or the lower (respectively 48 and 41%). Interestingly, for this study, predisposing conditions such as diabetes, peripheral vascular disease, cancer and alcohol abuse were observed each in less than 5% of patients.

Clinical aspects

       Patients with cellulitis usually present a localized tenderness, local heat, induration and erythema. During the examination, you must be alert to signs or lymphadenitis limfangitis; although rare, they may suggest a more serious infection. High fever and chills suggest bacteremia, particularly in patients with underlying medical conditions. Recurrent attacks can lead to impaired lymphatic drainage, edema, dermal fibrosis and thickening of the epidermis. These chronic changes are known as nostra elephantiasis and predispose patients to cellulitis attacks.

       If the patient is clinically healthy above the symptoms of cellulitis, the clinical picture is enough to establish the diagnosis for this disease. In patients with underlying diseases or signs of bacteremia, blood cultures are recommended and determination of the number of leukocytes. Local means of isolation of the organism are controversial, but in case a patient has apparently toxic manifestations, apparently it can help. It is often difficult to distinguish between deep vein thrombosis and cellulitis in the lower extremities and may be required a venogram or a Doppler ultrasonography.