CELLULITIS: A BACTERIAL SKIN INFECTION, THEIR CAUSES, DIAGNOSIS AND TREATMENT

Family physicians frequently treat bacterial skin infections in the office and in the hospital. Common skin infections include cellulitis, erysipelas, impetigo, folliculitis, and furuncles and carbuncles. Cellulitis is an infection of the dermis and subcutaneous tissue that has poorly demarcated borders and is usually caused by Streptococcus or Staphylococcus species. And that is characterized by warmth, edema, and advancing borders. Cellulitis commonly occurs near breaks in the skin, such as surgical wounds, trauma, tinea infections, or ulcerations. Patients may have a fever and an elevated white blood cell count. The most common sites of cellulitis were the legs and digits, followed by the face, feet, hands, torso, neck, and buttocks. For infection in patients without diabetes, empiric treatment with a penicillinase-resistant penicillin, first-genera- tion cephalosporin, amoxicillin-clavulanate (Augmentin), macrolide, or fluoroquinolone (adults only) is appropriate. Limited disease can be treated orally, but more extensive disease requires parenteral therapy. Antibiotics should be maintained for at least three days after the resolution of acute inflammation. Adjunctive therapy includes the following: cool com- presses; appropriate analgesics for pain; tetanus immunization; and immobilization and elevation of the affected extremity. The patient may also require a plain radiograph of the area or surgical debridement to evaluate for gas gangrene, osteomyelitis, or necrotizing fasciitis. Recurrent episodes of cellulitis or undergoing surgery, such as mastectomy with lymph node dissection.Herbal medicines are also used for cellulitis.