Key concepts
Infectious cellulite is a bacterial infection of connective tissue: it is an acute and severe inflammation of the dermis and subcutaneous layers.
The causative agents most involved in infectious cellulitis are Streptococci and Staphylococci. Haemophilus influenzae can also cause similar infections, especially in children. Immune-compromised patients are more exposed to the risk of infectious cellulitis than healthy ones
Infectious cellulitis: symptoms
Infectious cellulite manifests itself with redness, inflammation and cutaneous pain at the point of infection. The patient often complains of fever. Complications: lymphadenomegaly, papulo-pustular lesions on the skin, extension of infection in the blood, necrotizing fasciitis
Infectious cellulite: drugs
Antibiotics are the treatment of choice for the treatment of infectious cellulite. You can also take painkillers to mask the pain.
What is infectious cellulite?
Infectious cellulite is a fairly common and dangerous bacterial infection of connective tissue, characterized by severe inflammation of the skin and subcutaneous layers.
Not to be confused with aesthetic cellulite, infectious cellulite is triggered by a bacterial insult: at the point of infection, the skin appears red, inflamed, warm and soft to the touch. Infectious cellulite tends to spread rapidly, infecting even the other anatomical sites: when untreated, the infection can put the patient's life at risk. According to this, it is understandable how bacterial cellulite constitutes a medical emergency in all respects.
Despite the danger of the disease, the treatment is rather simple: a specific antibiotic therapy removes and kills the causative agent, favoring the complete recovery of the patient.
Due to the multiple affinities, infectious cellulite is often confused with erysipelas: an acute bacterial infection of the skin involving dermis, more superficial layers of the hypodermis and lymphatic vessels (it is therefore more superficial than infectious cellulite). However, many hospitalized patients with infectious cellulitis are also affected by erysipelas.
Causes and risk factors
CAUSES
Infectious cellulite is the expression of a bacterial insult: pathogens penetrate the skin through micro-lesions or large wounds.
The bacteria most involved in bacterial cellulite are:
- Streptococci (group A hemolytic beta Streptococcus pyogenes )
- Staphylococci ( Staphylococcus aureus ): in recent years, the cases of bacterial cellulitis mediated by the bacterium MRSA (acronym of Methicillin-resistant Staphylococcus aureus ) seem to increase. It is a staph resistant to beta-lactam antibiotics, including penicillins and cephalosporins.
Streptococci and staphylococci are the infectious agents most involved in bacterial cellulite; however, other aerobic and anaerobic bacteria can also trigger infection.
In children, infectious cellulite can also be caused by the bacterium Haemophilus influenzae .
RISK FACTORS
Bacterial cellulite can affect anyone; however, immunocompromised patients are the most at risk category.
The weakening of the immune system can be promoted by leukemia, HIV infections, chronic kidney diseases, liver diseases, altered blood circulation and diabetes. The abuse of some drugs (corticosteroids) also weakens the immune system.
Some diseases predisposing to infectious cellulite have also been identified; among these we remember:
- Fire of St. Anthony
- chickenpox
- eczema
- Athlete's foot
- Lymphedema: joint swelling makes the skin more susceptible to infection
- Obesity: increases the risk of both infectious cellulite and its relapsing forms
Symptoms
To learn more: Symptoms Infectious cellulitis
Infectious cellulite can involve every part of the body; nevertheless, the lower part of the legs is the most common target of infection.
At the point of infection, the skin is warm and soft to the touch, painful, swollen and reddened.
The formation of peculiar reddish streaks on the skin is an indication of bacterial diffusion in the lymphatic vessels: in similar circumstances, bacterial cellulite favors the formation of lymphadenomegaly.
It is not uncommon for the patient suffering from bacterial cellulitis to undergo a sudden alteration of the basal temperature (fever).
The clinical picture of the infectious cellulite patient can be complicated to the point of forming a papulo-pustular lesion on the skin. In severe cases, bacteria can infect blood (bacteremia).
Necrotizing fasciitis is a possible complication of bacterial cellulite: it is a rare inflammation with an infectious etiology, involving the deep layers of the skin and subcutaneous tissues. Necrotizing fasciitis, rapidly expanding through the connective tissue, constitutes a medical emergency.
Diagnosis and treatment
The anamnesis and physical examination are indispensable for a first approximate diagnosis. The suspicion of infectious cellulite can be ascertained by blood tests.
Differential diagnosis is important for distinguishing infectious cellulitis from other similar diseases:
- An ultrasound of the veins of the lower limbs detects the possible presence of a blood clot → differential diagnosis with deep vein thrombosis
- An X-ray radiograph ascertains or denies the spread of infectious cellulite to the bones
- The differential diagnosis must also be made with Lyme disease. The blood test can verify this anthropozoon or not. Normally, this test is recommended in countries where the disease is endemic, especially during the summer months.
Skin biopsy or culture (blood culture) are generally not necessary: in fact, it is not so immediate to isolate the pathogen involved in infectious cellulite.
Antibiotic treatment for bacterial cellulite should begin as soon as possible after the first symptoms appear. For mild forms, oral or intravenous administration of drugs such as Flucloxacillin or dicloxacillin is sufficient. The moderate and severe variants are treated with phenoxymethylpenicillin per os (a drug also indicated for the treatment of erysipelas); alternatively, administer benzylpenicillin or ampicillin / amoxicillin intravenously.
Infectious cellulite is often accompanied by pain and local irritation: to cope with constant pain perception, the administration of therapeutic aids (eg NSAIDs) is recommended.
In most cases, the symptoms of infectious cellulitis subside after 24-48 hours after antibiotic administration. However, it is recommended to complete the treatment cycle even in the event of complete remission of symptoms after a few days from the start of the treatment: by completing the antibiotic therapy, the risk of relapse of infectious cellulite is minimized.
See also: Drugs for the treatment of Infectious Cellulitis »
