Pathophysiology?
Inflammation of the skin and subcutaneous tissues, typically due to an infection
Common causative organisms?
Streptococcus pyogenes or Staphylcoccus aureus
Symptoms?
Erythema, pain and swelling. May be some associated systemic upset such as fever
Where does this commonly occur?
Shins
How to diagnose?
Clinically
When would you order bloods or blood cultures?
When you suspect septicaemia
What classification guide is used to guide management of patients with cellulitis?
Eron classification
How many classes in Eron classification and what do they each mean?
4 classes.
- No signs of systemic toxicity and no uncontrolled co-morbidities
- Pt is either systemically unwell or systemically well but with a co-morbidity which may complicate resolution of infection
- Pt has significant systemic upset such as acute confusion, tachycardia, tachypnoea, hypotension or unstable co-morbidities that may interfere with a response to treatment, or a limb threatening infection due to vascular compromise
- Pt has sepsis syndrome or a severe life-threatening infection such as necrotitizing fasciitis
Who should be admitted for IV antibiotics?
- Eron class 3 or 4
- severe or rapidly deteriorating cellulitis
- <1yr or frail pt
- immunocompromised
- has significant lymphoedema
- has facial cellulitis or periorbital cellulitis
Treatment for mild/moderate cellulitis?
Flucloxacillin
What treatments are recommended in patients allergic to penicillin?
Clarithromycin, erythromycin (in pregnancy) or doxycycline
Treatment for severe cellulitis?
Co-amoxiclav, cefuroxime, clindamycin or ceftriaxone.
