![]() ![]() Patients with cellulitis will reveal an affected skin area typically with a poorly demarcated area of erythema. Patients with comorbidities such as diabetes mellitus, venous insufficiency, peripheral arterial disease, and lymphedema are at higher risk of developing cellulitis. Risk factors for cellulitis include any culprit that could cause a breakdown in the skin barrier such as skin injuries, surgical incisions, intravenous site punctures, fissures between toes, insect bites, animal bites, and other skin infections. Cellulitis most commonly results from infection with group A beta-hemolytic streptococcus (i.e., Streptococcus pyogenes). The introduction of these bacteria below the skin surface can lead to an acute superficial infection affecting the deep dermis and subcutaneous tissue, causing cellulitis. When a break in the skin occurs, it allows for normal skin flora and other bacteria to enter into the dermis and subcutaneous tissue. The skin serves as a protective barrier preventing normal skin flora and other microbial pathogens from reaching the subcutaneous tissue and lymphatic system. If the clinician correctly identifies and promptly treats cellulitis, it typically resolves with appropriate antibiotic treatment. Patients who are immunocompromised, colonized with methicillin-resistant Staphylococcus aureus, bitten by animals, or have comorbidities such as diabetes mellitus may become infected with other bacteria. Beta-hemolytic streptococci typically cause cellulitis, generally group A streptococcus (i.e., Streptococcus pyogenes), followed by methicillin-sensitive Staphylococcus aureus. The infection is without an abscess or purulent discharge. It is an acute bacterial infection causing inflammation of the deep dermis and surrounding subcutaneous tissue. Cellulitis typically presents as a poorly demarcated, warm, erythematous area with associated edema and tenderness to palpation. It accounts for approximately 3.7 billion dollars in ambulatory care costs and 650000 hospitalizations annually. Cellulitis is a common bacterial skin infection, with over 14 million cases occurring in the United States annually. ![]()
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