A cellulitis is an infection of the soft tissue. This type of infection is
much different from osteomyelitis, which is an infection of the bone. A
the foot or lower leg is usually red, hot, swollen, and tender. A classic
description of cellulitis is "red streaking"
leading up the foot or
leg. Patients that are immunocompromized
or have weak immune systems are more likely to suffer from cellulitic
episodes. A cellulitic foot or leg can be very painful and can cause the
patient a great deal of disability.
If a cellulitis is not properly and aggressively treated, the infection may
spread quickly through the surrounding tissues
and become even more serious
requiring more aggressive treatment.
What causes it?
A cellulitic infection can be caused by a number of factors. A
"streptococcus" organism is the most common cause of cellulitis in the lower
extremity. In diabetics we many times see mixed infections causing
cellulites. These means that there are more than just one organism. Some
patients are more susceptible to cellulitic infections and have frequent
flare-ups of this localized soft tissue involvement. In cases of recurrent
cellulitic episodes, the lymph nodes can become scarred from the infection
and will become activated when the patient suffers from a stressful or
traumatic event. A small break in the skin, an ulceration, or an infected
toenail may lead to cellulitis. Poor hygiene may also predispose one to a
cellulitic infection as well as diabetes mellitus.
How is it treated?
Cellulitic infections are usually treated with antibiotics. Since cellulitis
is caused by a particular organism, an antibiotic is the standard of care.
Occasionally, when the infection is not localized and seems to be spreading
aggressively, an oral antibiotic may not be sufficient and IV antibiotics
are then used. Sometimes if an abscessed area exists it must be treated to
let the antibiotics get to the infected area. The major complaints by the
patient with a localized cellulitis are most often pain and swelling.
Therefore, elevation of the foot/leg is very important as is sufficient pain
control. Patient and doctor observation is another crucial factor in the
management of this condition. If a patient suffers from foot ulcerations or
has breaks in the skin, a careful ongoing monitoring program is needed to
prevent the spread of the infection.
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