What is Cellulitis? What is and what is not cellulitis is important in determining a possible microbiological etiology and treatment. Unfortunately, cellulitis is often used to describe a broad group of superficially Neratinib similar (e.g., diffuse and spreading) but often histologically distinct skin infections. The International Classification of Diseases version 9 (ICD-9) creates further confusion by combining cellulitis and abscess under a single code [12]. Cellulitis, as defined in the 2005 IDSA skin and

soft-tissue infection guideline, is a diffuse spreading infection with inflammation of the deeper dermis and subcutaneous fat. It excludes “infections associated with underlying suppurative foci, such as cutaneous abscesses, necrotizing fasciitis, septic arthritis, and osteomyelitis” [3]. This definition is largely histologic and excludes underlying complicating or complex lesions. It delineates cellulitis as the primary focus of infection and not one resulting from

contiguous extension. This definition does not, however, exclude the possibility of suppurative complications from cellulitis. Cellulitis is characterized by rapidly spreading areas of edema, redness, and heat, sometimes accompanied by lymphangitis and inflammation of the regional lymph nodes. Other manifestations such as vesicles, bullae, and petechiae or ecchymoses may develop on the inflamed skin. The affected integument may eventually develop a pitting orange peel appearance. Systemic manifestations are usually mild, but fever, tachycardia, confusion, hypotension, and leukocytosis may be present and occur selleck compound hours before the skin abnormalities appear. Vesicles and bullae filled with clear fluid

are common. The presence of severe pain, violaceous blisters or bullae, and petechiae or ecchymoses, if widespread or associated with systemic toxicity, may signal a deeper infection such as necrotizing fasciitis Dapagliflozin [3, 12, 13]. The etiologic agent of cellulitis is believed to be streptococci or Staphylococcus aureus in most cases but can vary depending on extenuating factors. These extenuating factors include physical activities, trauma, water contact, injection drug use or abuse and animal, insect, or human bites. Cellulitis that is diffuse or unassociated with a defined portal is believed to be caused by Streptococcus species [3, 12–16]. The general term cellulitis has also been applied to several diffuse spreading skin infections. Some of these do not meet the IDSA Guidelines definition. When used as a general term, the word cellulitis is usually preceded by some type of adjective such as purulent, suppurative, non-purulent, non-suppurative, necrotizing, synergistic necrotizing, periorbital, buccal, and perianal. Other forms of “cellulitis” are followed by “with” and a noun. These include cellulitis with abscess, cellulitis with drainage, and cellulitis with ulcer [12, 16, 17].