MF Blog 11 – Cellulitis

This is the first of my request blogs.

It is not about cellulite – which is different.

Well, what is cellulitis?

In its simplest sense it is an inflammation in the tissues of the body, not so much in the ‘cells’ themselves, although they are no doubt affected, more in the bits that hold us together – that which is not muscle, bone, nerve or fat (each of them have their own quite specific ‘itis’ – osteomyelitis being infection of bone, for example.)

‘Itis’ means inflammation (whenever I think of inflammation, I think of fire – as if whatever is inflamed is on fire, and, like fire is always easier to manage before it has taken-hold, in other words, don’t wait for the curtains to catch-light before doing something).

Our tissues are what hold us together, the bits in between the things that make us, us.

I appreciate I am not making this overly simple and I apologise, but please, bear-with.

Cellulitis is usually recognised by an area of painful redness in a body part; it is more often than not caused by a bacterial infection, the most common being Staphylococcus aureus. There I am showing off again with my Latin.

This is important, as it is the same family as MRSA – which is a bacterium that is resistant to antibiotics. (Methicillin (another name for Penicillin) Resistant Staphylococcus aureus)

In its most common form fortunately, antibiotics work; but I am getting ahead of myself.

Cellulitis, when the tissues become inflamed, often at the site of a break in the skin, for example, where an insect has bitten you or a rosebush scratched, this if you are unlucky, allows the bacteria to get inside and start multiplying.

As the bacteria increase in number, your body usually does its best to defend itself, and this is mostly when the pain, redness and general feeling of illness begins.

This is called in the medical world, an immune response – it is when your body acts in self-defence, sending white blood cells to the infection which in turn release poisons that try to do away with the bacteria.

Sometimes this works, often it doesn’t.

If your natural immune response is inadequate, the infection tends to get worse and people become more unwell – the fever climbs, the pain increases, and the redness grows.

As to why some people can get a scratch and are fine and others not, I don’t believe anyone fully knows, although mainly this has to do with whether the bacteria are present at the start, susceptibility plays a part too – people with diabetes, those taking steroids or who have poor circulation (e.g. smokers) are particularly prone.

Sometimes infections are introduced when patients are in hospital at the site of a needle or cannula; we call this Healthcare Associated Infection (HCAI) and something best avoided. (Make sure your doctor or nurse washes their hands).

The usual treatment for cellulitis is antibiotics – penicillin is still the most effective medicine, unless of course there is a risk of resistance (i.e. that penicillin will not work) in which case other antibiotics are usually added-in.

Sometimes doctors will draw marks around the infected area to measure success or not of the treatment; you could take a photo with your camera.

At other times the infection is attached to something that has gotten inside you, for example, a piece of glass – that is usually when you need someone more expert than me to help (surgeon or enthusiastic A&E doctor).

What can you do to help?

The most common advice is to rest and if possible elevate the limb – if it is a hand or foot that is affected as this will help your circulation and prevent something called venous stasis which tends to slow-down recovery (this is why people with swollen ankles (blog 6) are at higher risk of cellulitis and often recover more slowly).

Also, take the antibiotics if they are prescribed.

The infection can clear in a few days, sometimes it takes longer.

If the antibiotics don’t work in 48 hours or you are becoming more unwell, that is often a sign that you need something stronger, such as antibiotics directly into the veins; something that used to be done solely in hospital but is becoming more common in the community (i.e. you, the patient are at home receiving the treatment rather than a hospital ward).

To end on a note of caution, cellulitis despite being quite common and unpleasant can rarely be extremely severe and lead to life-threatening infections, rarely this can happen very quickly, over a matter of hours.

If you think you have cellulitis, probably best to get someone who knows what they are doing to have a look.

Right leg cellulitis

Hand cellulitis

Eye (peri-orbital) cellulitis