Cellulitis - Cellulitis
- Immunocompetent adults: Staphylococcus aureus and Streptococcus pyogenes. Staphylococcus aureus is the most frequent etiology in children and in purulent cellulitis.
- Immunocompromised individuals, including those with diabetes and decubitus ulcers: mixture of gram-positive cocci and gram-negative aerobes and anaerobes.
Fevers, chills, and malaise often precede the onset of cellulitis. Poorly defined borders, erythema, swelling, tenderness, and warmth characterize typical cellulitis lesions. In adults, the extremities are the most common sites affected. In more severe cases, additional clinical features may include vesicle and bulla formation, pustules, and necrosis. Complications are not common but can include glomerulonephritis, lymphadenitis, and subacute bacterial endocarditis.
A rising prevalence of MRSA has been identified as a pathogen of skin and soft tissue infections in otherwise healthy individuals lacking the aforementioned risk factors for cellulitis. MRSA should be considered for penetrating traumas, purulent infections, and in specific populations: athletes, children, prisoners, military service members, long-term care residents, and intravenous drug users. Other MRSA risk factors include recent admission to a health care facility, presence of an indwelling catheter, poor personal hygiene, and history of MRSA.
In all, the majority of cases of cellulitis resolve with appropriate antibiotic therapy. The decision to hospitalize a patient presenting with cellulitis will depend on the clinical picture and the patient's medical comorbidities. For any case of genital cellulitis, it is important to exclude Fournier gangrene.
Related topics: Orbital cellulitis, Preseptal cellulitis
L03.90 – Cellulitis, unspecified
128045006 – Cellulitis
- Contact dermatitis
- Herpes virus infections (herpes simplex virus or zoster with associated lymphangitic erythema)
- Fournier gangrene
- Gas gangrene
- Abscess (pilonidal or other)
- Hidradenitis suppurativa
- Genitourinary Crohn disease
- Fixed drug eruption
- Pyoderma gangrenosum
- Lymphogranuloma venereum
- Granuloma inguinale
- Tinea cruris
Last Updated: 10/10/2017