Cellulitis, acute

Acute, painless loss of vision Orbital cellulitis... 

Cellulitis is a bacterial infection of the dermis and subcutaneous tissue. S. aureus and P-hemolytic streptococci are the most common causes of acute cellulitis in otherwise healthy hosts. Persons who are immunocompromised, have vascular insufficiency, or use injection drugs are at risk for polymicrobial cellulitis. 

Carbuncles and furuncles that have surrounding cellulitis and fever or are located midline on the face must be treated systemically with an antibiotic that will cover Staphylococcus, such as dicloxacillin, cephalexin, or erythromycin. Treatment should continue until acute inflammation has resolved, usually a 5-10-day course. 

Suggested Alternatives for Differential Diagnosis Scarlet fever, cellulitis, cat scratch disease, gas gangrene, necrotizing fasciitis, tick-borne diseases such as Rocky Mountain spotted fever, pneumonia, septic shock, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation. 

Cellulitis is an acute, spreading infectious process that initially affects the epidermis and dermis and may subsequently spread within the superficial fascia. This process is characterized by inflammation but with little or no necrosis or suppuration of soft tissue. 

Acute cellulitis with mixed aerobic-anaerobic flora generally occurs in diabetes, where the skin is near a traumatic site or surgical incision, at sites of surgical incisions to the abdomen or perineum, or when host defenses are compromised. 

The goal of therapy of acute bacterial cellulitis is rapid eradication of the infection and prevention of further complications. 

Case study level 3 - Acute cellulitis - see page 297... 

Tracy Gamier and Gary Moss Case study level 1 - Cold sores 294 Case study level 2 -Severe acne 295 Case study level 3 - Acute cellulitis 297 Case study level Ma - Atopic eczema 298 Case study level Mb - Psoriasis 301... 

It is important to note that the acute lid edema occurring soon after the onset of viral invasion does not result from bacterial cellulitis and typically resolves within a few days without antibiotic therapy. 

The classical inflammation criteria such as exudation, cellulation and proliferation can only be applied to the liver with some reservations, since the emphasis in this instance is on the sinusoids, which already display maximum permeability under normal conditions. The increase in capillary permeability, required by the definition of infiammation, is really only applicable to the area of the vascularized portal fields, e.g. in purulent cholangitis. The definition of inflammation can only be applied to classic acute viral hepatitis, (s. p. 415)... 

Cellulitis is an acute, infectious process that represents a more serious type of SSTI. Cellulitis initially affects the epidermis and dermis and may spread subsequently within the superficial fascia. Cellulitis is considered a serious disease because of the propensity of the infection to spread through lymphatic tissue and to the bloodstream. S. pyogenes and S. aureus are the most frequent etiologic agents. However, a number of bacteria have been implicated in various types of cellulitis (see Table 108-1). The rising incidence of infections due to MRSA is a major concern in both the community and hospital settings. 

Acute cellulitis with mixed aerobic and anaerobic flora generally occurs in diabetics, where the skin is adjacent to some site of trauma, at sites of surgical incisions to the abdomen or perineum, or where host defenses have been otherwise compromised (vascular insufficiency). In older patients, cellulitis of the lower extremities also may be complicated by thrombophlebitis. Other comphcations of cellulitis include local abscess, osteomyehtis, and septic arthritis. ... 

The goal of therapy of acute bacterial cellulitis is rapid eradication of the infection and prevention of further complications. Antimicrobial therapy of bacterial cellulitis is directed against the type of bacteria either documented or suspected to be present based on the clinical presentation. Local care of cellulitis includes elevation and immobilization of the involved area to decrease swelling. Cool sterile saline dressings can decrease pain and can be followed later with moist heat to aid in localization of the cellulitis. Surgical intervention (incision and drainage) as a mode of therapy is rarely indicated in the treatment of cellulitis. 

Cellulitis—An acute, infectious process that initially affects the epidermis and dermis and may subsequently spread within the superficial fascia. 

Indications Common cold, wind, cold, damp evils. Upper respiratory tract infections, flus, emphysema, malaria, early stage dysentery, early stage measles, acute cellulitis, and sores... 

Indications Replete heat and fire toxins, exuberant heat in the three burners patterns. Septicemia, dysentery, pneumonia, acute urinary tract infections, ulcers, carbuncles, furuncles, boils, acute enteritis, acute icteric hepatitis, acute cholecystitis, encephalitis, acute conjunctivitis, acute pelvic inflammation, erysipelas, cellulitis, hemoptysis, epistaxis, urticaria, pruritus, cerebral hemorrhage, hypertension, anxiety, palpitations, insomnia, neurasthenia, and hysteria... 

H. influenzae, gonococci, and E. coli. It also is effective in the treatment of acute otitis media in children, sinusitis, animal or human bite wounds, cellulitis, and diabetic foot infections. The addition of clavulanate to ticarcillin (timentin) extends its spectrum to include aerobic gram-negative bacilli, S. aureus, and Bacteroides spp. There is no increased activity against Pseudomonas spp. 

Infection of the skin or other soft tissues of the upper extremities will be apparent as an acute inflammatory event with the usual signs and symptoms of pain, heat, swelling, redness, and tenderness to palpation. Infections may be localized or may be more diffuse as in cellulitis. 

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