Cellulitis Related Terms: lymphedema, erythema, staph aureus, strep A, gram-negative
bacteria, gangrene, tissue necrosis, septicemia, regional lymphadenopathy, Keflex, Augmentin, penicillins, pneumococcus, hemophilus influenzae, pasturella multocide,
erysipelothrix rhusiopathia, gram negative bacteria
Cellulitis
This is often our worst nightmare and sends us to the hospital more than anything else regarding
cellulitis, complications of and treatment for cellulitis and/. Acute Cellulitis
Acute Cellulitis is one of the complications of lymphedema. The patient may not be aware of the source of a cut, mosquito bite, open
in the body. The first sign is increased or different quality of PAIN involving the lymphedema
limb. The patients often describe this as a "flu like symptom or an ache" involving the Lymphedema arm or leg. This is usually followed by sudden onset of ERYTHEMA
(redness, red streaks or blotches) on the involved limb. The HYPERTHERMIA (lymphedema limb becomes warm, hot) will follow and the patient may experience
the CHILLS and even HIGH FEVER. The early intervention and treatment with antibiotics will resolve this condition (it usually takes a very minimum ten day course of antibiotics). Only a Medical Doctor us a consultation wi
necessary. Severe cellulitd hospitalization. Again, elevation of the affected limb is important.
During that phase the patient should NOT massage the lymphedema limb, bandage,
apply the , wear tight elastic sleeve or exercise excessively. Avoid the
and to be drawn from the involved arm. Keep the limb elevated as
much as possible while resting. Once the symptoms dissipate the treatment ould be initiated. How do we prevent this infection? The patient should be careful with daily activities and take all precautions to protect the skin (wear gloves when gardening, cleaning
with detergents, etc. ). If an injurs on the lymphedema limb it is necessary to clean the wound with alcohol or hydrogen peroxide and apply antibiotic
ointment. If the symptoms progress seek the attention of a physician immediately. It is so very important to avoid getting cellulitus as it further destroys the
lowed to spread or continue it can become n lead to
Clinical
Cellulitis is clinically a spreading infection involving both the dermis and
tissues. Unlike clear raised border. Other features may include red streaking from the infected area,
Symptoms
Symptoms include all over body ache, fever, severe pain of the infected area, chills,
weakness. The skin color will be red, warm and very tender to the touch.
The most common Other less common bacterial , and patients pneumococcus. Less common bacteria
such as Hemophilus influenzae, Pasturella multocide, and erysipelothrix rhusiopathiae can cause it as well.
Entry foci for the bacteria includes nasal cavities, wound, cuts, scrapes (any type of
skin break). Insect bites (especially spider) can cause the condition. Cat scratches, animal bites are another source of bacteria.
Risk Factors
Patients with any of the following disorders are more at risk for developing serious
Lymphedema, any type), Varicella (cellulitis as a complication of), us stasis,
chronic steroid users, post surgical patients, individuals with finally age may also be a factor with infants and the elderly more susceptible to infections.
Complications
Complications can include septicemia ), tissueamputation of the affected limb, death. It should be noted also that cellulitis causes
further damage to the makes lymphedema worse. Other complications include lymphangitis, skin .
In compromised patients, physicians must be careful to observe for a complicating gram-negative super infection that can accompany regu
This can occur as a result of the even further deplet
Other complications includ, if cellulitis is on
It is critical for patients with lymphedema to understand that every cellulitis infection further damages and scars the lymphatics and thereby worsens lymphedema.
Treatment
Cellulitis responds well to antibiotic therapy. Generally, a ten day course of
treatment is prescribed. Antibiotics used to treat cellulitis incl, and cs. In situations of a sed.
For special at risk patients, blood work may also be indicated to assure the infection has not become systemic.
This group, which includes lymphedema patients may need extended IV antibiotic
Prognosis
With early diagnosis and subsequent rapid treatment the outcome is actually
excellent with the overwhelming number of patients making full recovery. In special risk groups however, there is a heightened risk of complication and morbidity.
How can you prevent cellulitis? Preventative Antibiotic Therapy If you are particularly susceptible to infections, you may wish to discuss with your doctor about undertaking preventative antibiotic therapy. There are a couple ways of
doing this. Either an oral antibiotic or if you are not allergic to penicillin, you may well consider taking long acting penicillin injections. This worked wonderfully for me during the 1970's. Until my family allergy to penicillin raised its ugly head, this was perhaps the
most successful therapy I have had in preventing cellulitis. Remember one important point regarding cellulitis. With the bacteria is able
to "hide" in pockets and may escape the antibiotic or the fibrosis will make it much
more difficult for the antibiotic to be effective. Doing all you can to prevent infections is critical.
JOBNAME: cno 25#1 2005 PAGE: 1 OUTPUT: Fri February 11 20:34:45 2005lww/cno/94412/WNO160361Prod #: WNO160361Howard D. Pomeranz, MD, PhD and Abdhish R. Bhavsar, MDAbstract: Seven patients, aged between 50 and 69 years,had typical features of nonarteritic anterior ischemic opticThe medical records of seven patients in whomneuropathy (NAION) within 36 hours after ingestion ofNAION developed sub
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