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Cellulitis describes a deep infection of connective tissue, usually skin and
subcutaneous tissues, in which there is obvious oedema. Erysipelas is a form of
- some authors state that Group A beta haemolytic streptococcus
(Streptococcus pyogenes) is the major cause of celluluitis (1) whereas others
state that cellulitis is most frequently caused by Streptococcus pyogenes or Staphylococcus
- Stapylococcus aureus is a minor cause of the classic erysipelas
- Streptococcus pyogenes is the major agent of erysipelas, but also Staphylococcus
aureus may be the causative micro-organism
- microbiological spectrum
of cellulitis is wider than erysipelas including not only the mentioned staphylococci
and streptococci, but also other Gram-positive and Gram-negative micro-organisms,
including anaerobic bacteria (3)
Cellulitis presents as a hot, raised,
tender area of skin whose margin is less well demarcated than in erysipelas. Often,
the patient is systemically unwell with fever and rigors. An abrasion usually
allows the infective organism to enter the skin.
full blood count
- blood cultures
- swab analysis
is with systemic antibiotics, for example, oral penicillin V plus flucloxacillin
(or erythromycin alone) or co-amoxiclav alone. If cellulitis is severe then management
may require parenteral benzylpenicillin plus flucloxacillin OR co-amoxiclav alone.
I. Microbiology and management of soft tissue and muscle infections. J. Int. Surgery
H et al.Bacterial infections: uncommon presentations Clinics in Dermatology, Volume
23, Issue 5, September-October 2005, Pages 503-508.
- Lazzarini L et
a.. Erysipelas and cellulitis: clinical and microbiological spectrum in an Italian
tertiary care hospital. J. of Infect. 2005; 51 (5):383-389.
- BNF 5.1
Last edited 11/2019 and last reviewed 05/2020