Cellulitis_erysipelas%20(pediatric) Signs and Symptoms
Introduction
- An acute spreading skin infection that may go deep, involving the subcutaneous tissues
- Typically occurs in areas where the skin integrity has been compromised
- May also result from blood-borne spread of infection to the skin & subcutaneous tissues
Definition
Erysipelas
- A type of cellulitis w/ sharply demarcated margins involving the epidermis & superficial lymphatics
- Onset of symptoms is acute whereas cellulitis has an indolent course
- More commonly caused by beta-hemolytic streptococci
Etiology
- Commonly caused by beta-hemolytic streptococci & Staphylococcus aureus in adults, & Haemophilus influenzae type B in patients <3 years
- Infection due to streptococci is rapidly spreading because of streptokinase while that of staphylococci is localized
- Consider Methicillin-resistant S aureus (MRSA) in patients w/ recurrent cellulitis, or refractory to treatment
Uncomplicated cellulitis
- Beta-hemolytic streptococcal etiology in 90% of infections but S aureus is difficult to exclude especially if mixed infection occurs
Complicated cellulitis
- Group A streptococci, Staphylococcus aureus, H influenzae B, Enterobacteriaceae & anaerobes
Signs and Symptoms
- Rapidly spreading area of acute inflammation of the dermis & subcutaneous tissue
- Lymphangitis & inflammation of the regional lymph nodes may occur
- Area is usually tender, erythematous & warm to the touch
- Patient may have malaise, fever & chills
Risk Factors
- Obesity
- Diabetes mellitus & malignancy
- Immunocompromise
- Previous cutaneous damage
- Edema from venous insufficiency or lymphatic obstruction