Diagnostic Approach To Cellulitis
When evaluating a patient with cellulitis, review systemic features. Potential portals of entry for infection should also be looked for. These include:
- disruption to the skin barrier, insect bites, wounds, abrasions
- pre-existing skin infection, tinea pedis, impetigo
- underlying skin disease, eczema, psoriasis
- lymphoedema or surgical disruption of the lymphatic or venous system
- peripheral vascular disease with impaired arterial supply
- chronic venous insufficiency.
It is important to consider less common causes of skin infection associated with specific clinical circumstances or exposures . In these cases, specimens should be collected for culture and sensitivity testing and treatment regimens broadened to cover likely pathogens. In difficult-to-treat or atypical infections, specialist opinion is recommended.
Cellulitis Complications And How To Prevent Them
Untreated cellulitis can lead to some serious medical conditions, including:
- Infective endocarditis
- Glomerulonephritis
- Lymphadenitis
Another major complication is the infection spreading to your bloodstream, at which point the infection becomes life-threatening.
You can raise your chances of heading off complications by doing the following:
- See a doctor if you have signs or symptoms of cellulitis.
- Take your prescribed antibiotics as directed, and dont stop the medication early.
- Notify your doctor if your symptoms dont improve within three days of starting an antibiotic.
- Get plenty of rest to help your body heal faster. If the cellulitis is in your leg, elevate it to reduce swelling.
How Is A Spider Bite Diagnosed
Seeing the spider is the best way to confirm both a bite and the type of spider. Otherwise, there isnt a way to test for a spider bite or determine what bit you.
Your healthcare provider may make a diagnosis based on symptoms. Your provider may also send a sample of fluid from a blister to a lab to check for skin infections that cause similar symptoms, such as methicillin-resistant staphylococcus aureus .
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Which Spiders Are Dangerous To People
There are at least 60 different spider species in America, but only a few pose any danger to humans. These more dangerous spiders include:
- Black widows: These black spiders have a red hourglass shape on their bellies. Black widows like to build webs in woodpiles, building overhangs , fences and outhouses. They mostly live in the Western and Southern U.S.
Black widow spider
- Brown recluses: Sometimes called fiddleback or violin spiders, these brown spiders have a dark, violin-shaped mark on their heads. Brown recluses live in Midwestern and Southern states. They like dry, sheltered areas, such as piles of wood, rocks and leaves. Indoors, brown recluses seek out dark closets, attics and shoes.
Brown recluse spider
- Hobo spiders: These brown spiders have a grey V-shaped pattern on their bellies. They build funnel-shaped webs in dark, moist basements, crawl spaces, window wells and woodpiles. Hobo spiders are mostly found in the Pacific Northwest.
Hobo spider
How Long Does It Take For A Spider Bite To Heal
In most cases, you can expect a spider bite from a non-venomous spider to heal within a week. However, the skin at the center of the bite can often turn into an open sore or ulcer that gets continually bigger until the surrounding skin dies. This ulcer shouldnt persist in growing for more than two weeks, with full healing potentially taking a month or more.
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Flea Bites Vs Mosquito Bites
Fleas also feed off your blood and secrete saliva into your bloodstream. Flea bites look similar to mosquito bites and bed bug bites. Fleas travel by jumping, so their bites appear more random than bed bug and mosquito bites. Youre more likely to experience flea bites if you have dogs, cats or another pet that spends time outside.
If youre suffering from bug bites over a long period, your healthcare provider can help you identify the type of bite.
What Are The Signs & Symptoms Of Cellulitis
Cellulitis begins with a small area of skin that’s:
- tender
- warm
- red
As this area begins to spread, a child may begin to feel ill and get a fever and, sometimes, chills and sweats. Swollen lymph nodes are sometimes found near the area of infected skin.
The time it takes for symptoms to start varies, depending on which bacteria cause the cellulitis. For example, a child with cellulitis caused by Pasteurella multocida, often found in animal bites, can have symptoms less than 24 hours after the bite. But cellulitis caused by other types of bacteria may not cause symptoms for several days.
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Are There Different Kinds Of Ticks
Ticks are parasites that feed on warm-blooded hosts. They are related to mites and spiders because they are all arthropods. That means they have eight legs. There are many kinds of ticks. Some of the most common ticks in the U.S. include:
- Blacklegged tick, also known as deer ticks.
- Lone Star tick.
- Dog tick .
Ticks can vary in size and color. Some are larger. Some are brown or reddish-brown. Others are darker. Some have lighter markings on their backs.
Treatment Of Cellulitis With Systemic Illness
More severe cellulitis and systemic symptoms should be treated with fluids, intravenous antibiotics and oxygen. The choice of antibiotics depends on local protocols based on prevalent organisms and their resistance patterns and may be altered according to culture/susceptibility reports.
- Penicillin-based antibiotics are often chosen
- Amoxicillin and clavulanic acid provide broad-spectrum cover if unusual bacteria are suspected
- Cephalosporins are also commonly used
- Clindamycin, sulfamethoxazole/trimethoprim, doxycycline and vancomycin are used in patients with penicillin or cephalosporin allergy, or where infection with methicillin-resistant Staphylococcus aureus is suspected
- Broad-spectrum antibiotics may also include linezolid, ceftaroline, or daptomycin
Sometimes oral probenecid is added to maintain antibiotic levels in the blood.
Treatment may be switched to oral antibiotics when the fever has settled, cellulitis has regressed, and CRP is reducing.
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What Is The Prognosis For People Who Have Cellulitis
Most people feel better after about five days of taking antibiotics. Severe cellulitis may last two weeks or longer. To completely get rid of the infection, its important to take all of the antibiotics, even if you start to feel better.
Sometimes, symptoms get worse for a few days after you start treatment. This worsening of symptoms may be the result of bacteria dying off.
Having cellulitis once increases your risk of getting the infection again, usually in the same area. People who have weak immune or lymphatic systems are most at risk for recurrent cellulitis.
How Does A Tick Bite Affect My Body
You might not even know youve been bitten by a tick. Most dont cause pain or itching but some do. Some tick bites dont cause disease. Sometimes you can remove the tick before it can pass on any germs.
The tick bite itself may not cause symptoms except for some type of skin reaction, like a rash or a small hard lump. The infection that tick bites can give you may begin to cause symptoms.
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Portals Of Bacterial Entry
Cellulitis occurs where the skin has been broken. Trauma , insect bites, animal and human bites, surgical wounds, burns, sites of IV catheter insertion or IV injection of illicit drugs , and even small, imperceptible cracks in the skin predispose patients to cellulitis.
The infection is also associated with other skin conditions, including abscesses, furuncles, carbuncles, impetigo, varicella, and tinea pedis. When assessing patients with lower-extremity cellulitis, clinicians must be sure to examine the feet for interdigital dermatophytic infections and treat as necessary with topical antifungal agents.
Skin Care And Prevention
If you have a wound on your skin, keeping it clean and well cared for can help reduce your risk of cellulitis. And if you’re prone to skin cracks, either due to a condition such as eczema or because you have dry skin, applying a thick moisturizer can help create a barrier against bacteria and protect against infection.
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How Periorbital Cellulitis Is Diagnosed
If your doctor suspects periorbital cellulitis, theyll begin by a physical examination of your eyes for signs of injury.9
In addition, your doctor may examine your eye movements and response to light.
They may use tools such as X-rays and CT scans to have a clear picture of the infected area.
If your doctor suspects that underlying problems are the cause of the infection, they will do further investigation.
In this case, they may take a fluid sample such as blood cultures from the affected eye or other areas to find out the type of bacteria causing the problem.
For example, if sinusitis is the suspected cause, your doctor will take a sample of the paranasal sinus fluid to investigate further.
The paranasal sinus is the drainage that keeps the nose free of harmful bacteria. It is located in your head near the nose and eyes.
Once your doctor identifies the bacteria causing your eye infection, they will then proceed to administer treatment.
How Can I Protect Myself From Spider Bites
To protect yourself and your family from spider bites:
- Apply insect repellant thats registered with the Environmental Protection Agency .
- Keep firewood outside and check it for spiders before bringing it into the house.
- Shake your shoes, hats and gloves to check for spiders before putting them on.
- Treat clothing and shoes with permethrin, an insecticide.
- Wear gloves when carrying wood, working in the garden, moving rocks or in other outdoor settings.
- Wear long sleeves and pants in wooded areas.
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What Are The Symptoms Of A Mosquito Bite
The symptoms of a mosquito bite can vary. If the mosquito has a disease or an allergic reaction occurs, the symptoms could be more severe.
The common symptoms include:
- A raised, circular bump on the skin where the mosquito bite occurred.
More severe symptoms can include:
- An allergic reaction .
- Infection of a disease carried by a mosquito .
What Does A Spider Bite Look Like
Unless you literally saw the spider bite or simply recall seeing one in your room earlier in the day, odds are that you wont be able to tell the difference between a spider bite and a bee sting or another bug bite! Still, here are some indicators to look out for:
- Swelling
- Camel spider
- Wolf spider
Bites from these types of spiders should not be taken lightly! Black Widow and Brown Recluse spider bites can be life-threatening, as well as those of other venomous spiders. Seek medical attention if you suspect that youve been bitten by one of these.
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Dental Abscess With Facial Cellulitis
A dental abscess is an infection at the base of a tooth. It means a pocket of fluid has formed at the tip of a tooth root in your jawbone. If the infection isnt treated, more serious infections may spread to the face . This makes your face swell. Facial cellulitis is an infection of the skin and underlying soft tissues. This is a very serious condition. Once the infection and swelling starts, it can spread quickly.
A dental abscess often starts with a crack or cavity in a tooth. The pain is often made worse by having hot or cold drinks, or biting on hard foods. The pain may spread from the tooth to your ear, or to the area of your jaw on the same side.
Bed Bug Bites Vs Mosquito Bites
Like mosquitoes, bed bugs feed off your blood and secrete saliva into your bloodstream. Bed bug bites look similar to mosquito bites. However, bed bug bites often exhibit a distinct line or zigzag pattern. Bed bugs are active at night, and theyll bite your exposed skin while youre sleeping, including your face, hands, arms, feet and legs.
If youre suffering from bug bites over a long period, your healthcare provider can help you identify the type of bite.
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If Your Bite Has Gotten Worse
Keep an eye on any area of skin where you suspect a spider bite. Symptoms that get worse over time may indicate that you were bitten by a venomous spider or that the bite is infected.
Worsening symptoms include:
In many cases, you can treat a spider bite at home. You may experience mild symptoms for 1 to 2 days. Bites that itch or are infected may require more treatment and a consultation from a doctor.
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Antibiotics For Bug Bites
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When Should I Call The Doctor
- Any area of your childs skin becomes red, warm, and painful with or without fever and chills. This is even more important if the area is on the hands, feet, or face, or if your child has an illness or condition that suppresses the immune system.
- Your child gets a large cut or a deep puncture wound.
- An animal bites your child, especially if the puncture wound is deep. Cellulitis can happen quickly after an animal bite. Human bites can cause skin infections too, so call the doctor if this happens.
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Causes Of A Bug Bite Infection
All bug bites can lead to infection because they are caused by breaks in the skin. Fortunately, most bug bites do not become infected.
Bugs that people typically encounter include:
- Fleas
- Flies
- Spiders
The most common bacterial organisms that cause a skin infection after a bug bite are group A Streptococcus and Staphylococcus aureus. These bacteria are generally found in the environment and on the skin. They can enter the body when the bite of a bug punctures it. The bacteria do not come from bug saliva.
The bacteria can also enter the body when a person scratches at the bite, since scratching also breaks the skin.
Special Precautions For People With Diabetes
People with diabetes, in particular, should take meticulous care of their feet and be aggressive with treating even minor skin issues, says Dr. Adalja. Athletes foot can cause skin to be more prone to bacterial infection, so this should be treated promptly. Also, they should receive routine podiatric care.
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What Are The Risk Factors For Cellulitis From A Bug Bite
Children spend more time outside and tend to get more bug bites than adults. Their fingernails are often dirtier, too. These factors increase a childs risk for cellulitis.
If you have a weak immune system due to autoimmune disease, cancer or another illness, you may be more prone to cellulitis. The immune system helps your body fight off infections.
Other cellulitis risk factors include:
- Chronic edema .
- Swollen lymph nodes.
- Yellow, pus-like discharge from the bite.
You can use a washable marker to draw a border around the red, swollen bug bite area to track its size. You should contact your healthcare provider immediately if redness, swelling or blisters expand outside this border. Your provider may monitor the bite infection this way to make sure the infection clears up with treatment and doesnt get worse.
What Causes Cellulitis
Cellulitis is usually caused by a bacterial infection.
The bacteria can infect the deeper layers of your skin if it’s broken, for example, because of an insect bite or cut, or if it’s cracked and dry.
Sometimes the break in the skin is too small to notice.
You cannot catch cellulitis from another person, as it affects the deeper layers of the skin.
You’re more at risk of cellulitis if you:
- have poor circulation in your arms, legs, hands or feet, for example, because you’re overweight
- find it difficult to move around
- have a weakened immune system, for example, because of chemotherapy treatment or diabetes
- have lymphoedema, which causes fluid build-up under the skin
- inject drugs
- have a wound from surgery
- have had cellulitis before
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When To See A Doctor
Cellulitis isnt always an emergency but it does need treatment. If the area of red, inflamed skin does appear to be expanding but you have no other signs of a worsening infection, you can call your doctor and request an office appointment.
The Healthline FindCare tool can provide options in your area if you dont already have a doctor.
However, if the tender, swollen spot is growing or you show signs of a worsening infection, such as a fever or chills, you should seek emergency medical attention. Your infection may become serious if its not treated quickly.
One way to monitor the inflamed area for growth is to gently draw a circle around the swollen area of skin. A felt-tip marker may be more comfortable than a ball-point ink pen. Then, check the circle and skin two to three hours later. If the redness is beyond the circle you drew, the inflammation and infection are growing.
