CELLULITIS

Cellulitis is a  spreading subcutaneous inflammation caused by haemolytic streptococcus .Streptococcal infection produces diffuse inflammation because of hyaluronidase and streptokinase.Net result is that the inflammatory exudate spreads in the sub-cutaneous and facial planes resulting in a gross swelling in the affected part.Wherever there is a loose sub-cutaneous tissue as in scrotum or loose connective tissue and interstitial tissue as in face,forearm,it spreads fast.

Sources of Infection:

• Injuries--Major or minor
• Graze or scratch
• Snake bite,scorpion bite,etc.

Precipitating Factors:

• Diabetes
• Low resistance of an individual

Common Sites:

• Lower limb
• Face
• Scrotum

Clinical Features:

• Inflammation such as redness.
• Itching followed by diffuse swelling.
• Skin is stretched and shiny.
• Pain
• Fever
• Toxemia

If untreated:

• Suppuration 
• Sloughing
• Gangrene can occur.

Treatment:

• Bed rest with legs elevated .Reduces Oedema of leg as in cellulitis of leg.
• Glycerine Mg2SO4 dressing which reduces oedema of the part by osmotic effect.
• Diabetes ,if present ,is treated with injection Crystalline Insulin given subcutaneously.
• Appropriate Antibiotics:

1. Injection Crystalline Penicillin 10 lakh units, Intramuscular(I.M) or Intravenous (I.V)  6 hourly for 5-7 days
2. Ciprofloxacin 500mg twice a day can be given .

• Anti -snake Venom is given in snake bites cases.

Complication :

• Cellulitis can turn into an abscess which needs to be drained.
• Gangrene of the skin and subcutaneous tissue can occur.It is treated by debridement and skin grafting later.
• Toxemia and septicemia.
• Cellulitis can precipitate Ketoacidosis in a patient who has diabetes.