Cellulitis, What You Need to Know

Cellulitis is defined as an infection of the skin and is something many of us may have already experienced since living with a spinal cord injury (SCI). I know I have but I’ll share that part of my experience in a bit. First, let’s review what cellulitis is for those who have been extremely lucky to avoid it.

Cellulitis is a tremendously common but potentially serious bacterial skin infection. The affected skin appears swollen and red and is typically painful and warm to the touch. It’s this part that causes many of us to miss it because we are unable to feel the pain and warmth. Cellulitis usually affects the skin on the lower legs, but it can occur in the face, arms, and other areas. It occurs when a crack or break in your skin allows bacteria to enter. Left untreated, the infection can spread to your lymph nodes and bloodstream and rapidly become life-threatening.

Several years ago, I had a small cut on my right toe that I overlooked. Eventually, my right leg became larger than the other and I had redness and warmth to the touch at the site. Being a nurse, I was confused as to the culprit. I immediately went to the Emergency Department and a scan was done to rule out a blood clot because the symptoms are very similar. (See our article about deep vein thrombosis or DVT). I had cellulitis from that small cut, I was hospitalized overnight with IV antibiotics and then discharged on oral (by mouth) antibiotics. I am getting ahead of myself but I want to emphasize how dangerous cellulitis can be. Back to our cellulitis details.

What causes Cellulitis:

Cellulitis occurs when bacteria, most commonly streptococcus and staphylococcus, enters through a crack or break in your skin. However, the incidence of a more serious staphylococcus infection called Methicillin-Resistant Staphylococcus Aureus (MRSA) is on the rise.

Possible signs and symptoms of cellulitis:

• Reddened area of skin that tends to expand

• Swelling of area

• Tenderness (may be difficult to assess)

• Pain (also may be difficult to assess)

• Warmth to touch

• Fever

• Red spots

How is cellulitis diagnosed? Diagnosis is usually based on a medical history and physical exam. Blood and skin samples may be taken to confirm the diagnosis and the type of bacteria present. This helps guide treatment with the proper antibiotic. Treatment: To care for any symptoms of cellulitis, you should:

• Take the entire course of antibiotics (oral, injection, IV, or topical) as directed.

• Keep the area clean and apply dressings as instructed.

• Rest the area.

• Elevate the area to ease swelling and discomfort.

• Use over-the-counter pain relievers like acetaminophen or ibuprofen to ease the pain, as well as keep your fever down.

What are possible complications of cellulitis? In most cases, cellulitis is easily treated with no complications. But in some cases, complications of cellulitis can be very serious. These can include extensive tissue damage and tissue death (gangrene). The infection can also spread to the blood, bones, lymph system, heart, or nervous system. These infections can lead to amputation, shock, or even death. Prevention: Persons with decreased circulation, and that’s many of us with an SCI, and those who have diabetes, need to take extra precautions to prevent skin injury. Good skincare measures include the following:

Inspect your feet daily. Examine your feet frequently for any signs of injury or infection.

• Moisturize your skin regularly. Lubricating your skin helps prevent cracking and peeling but avoid moisturizer to any already open areas of your skin.

• Trim your fingernails and toenails carefully. Take care not to injure the surrounding skin.

• Protect your hands and feet. Wear appropriate footwear and gloves if needed.

• Promptly treat any openings on the skin's surface. Keep those areas clean and dry.

Cellulitis can be challenging to identify early and can progress quickly so when in doubt contact your health care provider promptly. It’s all good, so keep on rollin’, Patty, BSN, RNC and Roberta, RN The Rollin’ RNs ™ Cellulitis. https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762 Cellulitis. https://www.webmd.com/skin-problems-and-treatments/guide/cellulitis#2-5 Cellulitis. https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cellulitis.html