Cellulitis is a common infection of the lower layers of skin (dermis) and the subcutaneous tissues (areas
underneath the skin) caused by a spreading bacterial infection of the skin and tissues beneath the skin.
The main bacteria involved in cellulitis are Staphylococci are the bacteria that most commonly cause
cellulitis, followed by Streptococci. Less commonly, other types of bacteria may cause cellulitis.
What does cellulitis look like?
Cellulitis usually begins as a small area of pain and redness and tenderness , swelling, and redness. As
this red area begins to enlarge, the person may develop a fever—sometimes with chills and sweats—
and swollen lymph nodes ("swollen glands") near the area of infected skin.
The signs of cellulitis include redness, warmth, swelling, and pain in the involved tissues. Any skin
wound or ulcer that exhibits these signs may be developing cellulitis.
Cellulitis is a common infection of the lower layers of skin (dermis) and the subcutaneous tissues (areas
underneath the skin) caused by a bacterial infection. While cellulitis sometimes develops around
wounds in the skin or surgical incisions, in other cases it arises without an obvious source for the
bacterial infection. Staphylococci are the bacteria that most commonly cause cellulitis, followed by
Streptococci. Less commonly, other types of bacteria may cause cellulitis.
What are the symptoms of cellulitis?
Cellulitis usually begins as a small area of pain and redness on the skin. This area spreads to
surrounding tissues, resulting in the typical signs of inflammation – redness, swelling, warmth, and pain.
A person with cellulitis can also develop fever and/or swollen lymph nodes in the area of the infection.
Who is at risk for cellulitis?
Anyone may develop cellulitis. Males and females and people of all races are equally likely to become
infected. However, people whose immune systems are weakened for any reason (including from
chemotherapy for cancer or other immune-suppressing drugs) and those with diabetes are at highest
risk for developing cellulitis.
Antibiotics are essential for the treatment of cellulitis. Penicillin derivatives are often prescribed to treat
cellulitis, but other antibiotics can also be effective. In more advanced cases of cellulitis, hospitalization
and administration of intravenous antibiotics may be required. If not appropriately treated, the bacterial
infection can spread throughout the body, resulting in serious illness.
Definition
Cellulitis refers to an infection of the skin that may spread to tissue just beneath the skin's surface. It may occur
anywhere on the body, but most commonly affects the face or lower legs.
Causes
Cellulitis is usually caused by a bacterial infection. The infection may come from bacteria that normally lives on
the skin or bacteria from other sources. The bacterial infection may be caused by:

A minor injury to the skin, such as a cut, scratch, blister, puncture, or bite, that becomes infected and
spreads into the surrounding skin

Chickenpox blisters that open up and become infected with bacteria

Injuries that occur in natural bodies of water that become infected with germs found in the water

A cut or abrasion that becomes infected by food bacteria while handling fish, poultry, eggs, or meat

Bacteria that enter the body through surgical wounds or a catheter in a vein

Infection in a person with diabetes or a weakened immune system

Bacteria spreading from an upper respiratory or ear infection

Impaired circulation (tends to cause recurrence of cellulitis)
Puncture Wound
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:

Insect, animal, or human bites

Diabetes

Weakened immune system, such as AIDS

Alcoholism

Chronic use of steroids

Kidney and liver failure

Surgical procedures

Poor circulation or peripheral vascular disease

Swelling or fluid retention

Intravenous drug abuse

Burns

Exposure to fish, meat, hides, shellfish, poultry, or eggs
Symptoms
Symptoms may begin within hours or days and can include:

Skin inflammation that begins in a small area and spreads. This includes:
o
Redness
o
Pain or tenderness
o
Swelling
o
Warmth
o
A red streak (possibly)

Swollen lymph nodes

Fever or chills

Fatigue

Headache

Cellulitis near the eyes may cause pain with eye movements and should be treated urgently
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Expect to answer
questions about how the wound occurred and exposure to animals or natural bodies of water. Your skin will be
closely examined. Using a colored pen on your skin, the doctor can mark the border of the cellulitis to monitor its
progress.
Tests may include:
Wound culture—a sterile applicator swabbed across the area and sent to a lab to be tested for bacteria and type of
antibiotics to use in treating the infection. (This test is rarely, if ever, performed anymore since the bacteria on
the swab will reflect the bacteria that colonize our skin normally and, hence, the test is not useful.)
Blood tests—to help determine the severity of the infection
X-rays, bone scans, or CAT scans—to check for gangrene under the skin or evidence that the infection has spread
to the bone
Treatment
The treatment goal is to eliminate the infection and reduce discomfort. Most cases of cellulitis resolve after a
week or two of treatment. An infected wound can be cleaned and any dead tissue removed. If a collection of pus
(called an abscess) is present, it can be drained. Severe cellulitis, cellulitis in a diabetic or immune suppressed
person, or an infection on the face may require hospital care.
Treatment includes:
Medication
Antibiotics may be taken by mouth or injected into a muscle or vein, depending on the severity of the infection.
Take the entire prescription as directed until all the medicine prescribed is used. Otherwise, the infection may
return.
Supportive Care
This may include resting in bed or elevating the infected area higher than your heart. The doctor might
recommend applying warm or cool compresses to the area. Change your dressings as directed by your doctor, and
protect your skin from additional injury. Do not scratch or rub the area.
Facial cellulitis is a bacterial skin infection that occurs on the face. The
infection is characterized by swelling, redness, warmth, and pain. Risk
factors for the condition include problems in the lymphatic system,
upper respiratory infections, and infections of the teeth or middle ear.
In addition to the appearance of the skin in the affected area,
symptoms of facial cellulitis may include fever, chills, irritability, and a
swollen, tender, warm tongue. Treatment for facial cellulitis involves
antibiotics and recurrence prevention.
The most common cellulitis cause in adults with no medical conditions is group A
streptococcus, which is a bacterium commonly found in the throat and on the
skin.
Another common cause in adults is Staphylococcus aureus (S. aureus), which is a
bacterium that is commonly found on human skin and mucosa (lining of mouth
and nose).
Other Cellulitis Causes
In rare cases, other bacteria can cause cellulitis. When this does occur, it is
usually the result of a medical condition such as diabetes, HIV, or AIDS, or
because the cellulitis is in a very specific place.
Other bacteria that can lead to cellulitis include:

Methicillin-resistant S. aureus (MRSA)

P. aeruginosa

Vibrio vulnificus

Clostridium septicum

Pasteurella multocida

Erysipelothrix

E. coli

Group B streptococcus.
Know the Risk Factors
Cellulitis research has shown that people with certain risk factors are more likely
to develop the infection. Generally, cellulitis risk factors include:

Problems with the lymphatic system

Vein problems

Swelling of the leg

Breaks in the skin

Obesity.
Specific cellulitis risk factors include:

Surgical wounds

Skin ulcer (such as a diabetic foot ulcer)

Athlete's foot

Eczema, psoriasis, or other skin conditions that may cause a break in
the skin

A previous episode of cellulitis

Surgery with lymph node removal

Radiation therapy

Coronary artery bypass surgery

IV drug use

Chemotherapy

Pregnancy

Certain conditions (such as diabetes, HIV or AIDS, leukemia,
lymphoma, psoriasis, dyshidrosis, lupus, and heart failure).
Risk factors for cellulitis are not causes of the condition; however, such risk
factors do increase a person's chance of developing the infection. People who
think that they may be at risk of developing cellulitis should discuss this concern
with their doctor.
Symptoms of Facial Cellulitis
Facial cellulitis symptoms occur at the location of the infected skin (local
cellulitis symptoms) or on other parts of the body (systemic cellulitis
symptoms).
Common local and systemic symptoms of facial cellulitis include:

Fever

Irritability

Swelling and redness of the cheek

Itching and burning of the cheek

Swollen, tender, warm tongue.
Other symptoms of facial cellulitis may include:

Chills

Body aches

Vomiting

Decreased appetite.
Diagnosing Facial Cellulitis
Your doctor can make a facial cellulitis diagnosis by asking a number of
questions, reviewing your medical history, performing a physical exam, and
ordering certain blood tests. The most reliable way of diagnosing facial cellulitis is
by examining the affected area. An area affected by cellulitis will be:

Red

Warm to the touch

Swollen

Painful.
Your doctor will also look for breaks in your skin (such as cuts, bruises, scrapes,
eczema, or other skin conditions) where bacteria could have entered. A blood test
can determine if there is any indication of an infection.
Treatment of Facial Cellulitis
The goal of facial cellulitis treatment is to treat the affected area and any
underlying conditions that would cause a reoccurrence. Specific treatment for
facial cellulitis includes antibiotics and recurrence prevention.
Facial cellulitis treatment will begin with antibiotics. Depending on the severity of
facial cellulitis, antibiotics are given either in the hospital, at home, or in a
combination of these two locations. Be sure to tell your doctor if you are allergic
to penicillin.
Up to 30 percent of people who receive treatment for facial cellulitis will
experience a recurrence of the infection. Therefore, doctors may prescribe
antibiotics for longer periods of time for patients who continue to get facial
cellulitis.