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Disease: Cellulitis Cellulitis
Category: Dermatological diseases

Disease Definition:

One of the common, potentially serious bacterial skin infections is called cellulitis, which may spread rapidly; it appears as a swollen, red area of skin that feels hot and tender.


Though cellulitis can occur anywhere on the body or face, skin on lower legs are most commonly affected. In children and older adults, infections on the face are more common. Cellulitis may affect the tissue underlying the skin and can spread to the lymph nodes and bloodstream, or it may affect only the skin's surface.


If cellulitis symptoms occur, seeking immediate medical attention is important because the spreading infection may rapidly turn life-threatening when leaving it untreated.


Work Group:

Symptoms, Causes


When the skin is warm, tender, swollen and red, it may indicate symptoms of cellulitis. Fever may accompany the changes in the skin, and the area of redness tends to expand over time. On the top of the reddened skin, small red spots may appear, and small blisters may form and burst in less common cases.


When one or more types of bacteria enter trough a crack or break in the skin, cellulitis occurs. Staphylococcus and streptococcus are the most common types of bacteria that cause cellulitis. The occurrence of a more serious staphylococcus infection called methicillin-resistant Staphylococcus aureus (MRSA) is increasing.


The most common location for cellulitis to occur is the legs, near the shins and ankles in particular, although it can occur anywhere on the body. The most likely areas for bacteria to enter are disturbed areas of skin, like where one had recent surgery, dermatitis, athlete's foot, an ulcer, cuts or puncture wounds.


The bacteria that start the infection can be transmitted by certain types of insect or spider bites. An entry point for bacteria can be areas of dry, flaky skin, as well as swollen skin.


The risk of developing cellulitis may increase due to the following factors:

Chickenpox and shingles:

Broken blisters on the skin that can serve as potential entry points for bacterial invasion and infection are typically caused by these common viral diseases.

Intravenous drug use:

There is a higher risk of developing cellulitis in people who inject illicit drugs. 

Weakened immune system:

A person becomes more susceptible to infections such as cellulitis because of illnesses that result in weakening of the immune system. These illnesses include HIV infection and chronic lymphocytic leukemia. A person may become more vulnerable to infections when taking immune-suppressing drugs, such as cyclosporine or prednisone. Those immune-suppressing drugs are used to help prevent rejection in people who receive organ transplants, and to treat a variety of illnesses.


The circulatory system becomes less effective at delivering blood with its infection-fighting white blood cells to some areas of the body as one ages. So where the circulation is poor, skin abrasions may lead to infections.

Chronic swelling of the arms or legs (lymphedema):

The skin may be left vulnerable to bacterial infections when swollen tissue cracks.

Chronic fungal infection of the feet or toes:

Increasing a person’s risk of bacterial infection, cracks in the skin can be caused by recurrent fungal infection of the feet or toes.


Having diabetes impairs the immune system and increases the risk of infection, and it also increases the blood sugar level. The skin is one of the many areas of the body that becomes more susceptible to infections. Potentially leading to chronic ulcers of the feet, decreased circulation of blood to a person’s lower extremities may be the result of diabetes. These ulcers can be portals of entry for bacterial infections.



A deeper, more serious infection of the inner layers of skin may be signaled by thus reddened skin or rash. Entering the lymph nodes and the bloodstream and spreading throughout the body, the bacteria can spread rapidly once it becomes below the skin.


The infection can spread to the deep layer of tissue called the fascial lining in rare cases. An example of a deep-layer infection is flesh-eating strep, which is called necrotizing fasciitis as well. This represents an extreme emergency.


A prescription oral antibiotic may be included in cellulitis treatment. To ensure that the infection is responding to treatment, the patient will likely recheck with the doctor one to two days after starting an antibiotic. The patient will need to take the antibiotic for 10 to 14 days. Signs and symptoms of cellulitis disappear after a few days in most cases. However, the patient may need to be hospitalized and receive antibiotics intravenously if signs and symptoms don't clear up, are extensive, or if the patient has a high fever.


A drug that's effective against both streptococci and staphylococci is usually prescribed, such as cephalexin. Based on the circumstances of the patient, the doctor will choose an antibiotic.


Taking the medication as directed and finishing the entire course of medication is important even if the patient starts feeling better, no matter what type of antibiotic the doctor prescribes.


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