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- An acute bacterial skin and skin-structure infection (ABSSI) of the dermis and subcutaneous tissue; commonly characterized by pain, erythema, warmth, and swelling:
- Periorbital cellulitis: Bacterial infection of the eyelid and surrounding tissues
- Orbital cellulitis: Infection of the eye posterior to the septum; sinusitis is the most common risk factor.
- Facial cellulitis: Preceded by URI or OM
- Buccal cellulitis: Infection of cheek in children associated with bacteremia.
- Peritonsillar cellulitis: Common in children associated with fever, sore throat, and “hot potato” speech.
- Abdominal wall cellulitis: Common in morbidly obese.
- Perianal cellulitis: Sharply demarcated, bright, perianal erythema.
- Necrotizing cellulitis: Gas-producing bacteria in the lower extremities; common in diabetics.
- System(s) affected: Skin/Exocrine
Predominant sex: Male = Female (perianal cellulitis more common in boys)
200 cases per 100,000 patient-years
- Disruption to skin barrier: Trauma, infection, inflammation, edema, and lymphatic obstruction
- Increased risk factor: Elderly, diabetes, hypertension, obesity (1)
- Recurrent cellulitis: Immunocompromised, diabetes, hypertension, cancer, peripheral arterial or venous diseases, chronic kidney disease, dialysis, IV or SC drug use
No genetic pattern
- Maintain good skin hygiene.
- Wear support stockings to decrease edema.
- Maintain tight glycemic control and proper foot care for diabetics.
Cellulitis is caused by bacterial penetration through a break in the skin. Hyaluronidase mediates SC spread.
- Beta-hemolytic streptococci (groups A, B, C, G, and F), Staphylococcus aureus, including MRSA and gram-negative aerobic bacilli
- Staphylococcus aureus: Periorbital and orbital cellulitis and IV drug users
- Pseudomonas aeruginosa: Diabetics and other immunocompromised patients
- Aeromonas hydrophila and Vibrio vulnificus: Cellulitis caused by waterborne pathogens
- Haemophilus influenzae: Buccal cellulitis
- Clostridia and non–spore-forming anaerobes: Necrotizing cellulitis (crepitant/gangrenous)
- Streptococcus agalactiae: Cellulitis following lymph node dissection
- Pasteurella multocida and Capnocytophaga canimorsus: Cellulitis preceded by bites
- Streptococcus iniae: Immunocompromised hosts
- Rare causes: Mycobacterium, fungal (mucormycosis, aspergillosis, syphilis)