About Cellulitis - Inflammation of Tissue Cells

Cellulitis is inflammation of the tissue just below the skin. It most often occurs on the legs, face and neck. The cells become infected causing redness, pain, and swelling. If untreated, the infection may spread to the lymphatic system or to the blood stream causing bacteremia.

Orbital cellulitis which is infection of the tissue surrounding the eyes is a more serious form of this infection. It is characterized by redness, swelling of the eyelids pain and tenderness. Because of the seriousness of the infection there may be loss of vision, blindness, meningitis, brain abscess or even death.

The infection is caused by the streptococcus pyogenes or the staphylococcus aureus. It can be picked up from someone who has a strep throat or by direct contact with infected lesions. In children orbital cellulitis may be caused by the haemophilus influenzae.

Causes and risk factors: Most cases of orbital cellulitis are as a result of upper respiratory tract infection and sinus infection. It can occur after surgery of the face. Those that are especially at risk are those with existing medical conditions such as:

• Cancer
  
• Diabetes
• Kidney disease
• AIDS
• Those with organ transplant
  
• Those on steroids
• Those with reduced blood circulation

Signs and symptoms are:

• Pain
• Redness
• Swelling
• Fever
• Chills
• General malaise
• The area will feel overly warm

When the lymph vessels are infected a thick red line can be seen leaving the area and extending to the heart. In orbital cellulite the eyelids become swollen and the eyes may bulge.

Diagnosis: Diagnosis is made by taking a medical history and by assessment of the symptoms. A swab from any infected wounds or lesions can be obtained for culture and sensitivity. Blood tests for blood cells count would show increased white blood cells as the body tries to fight the infection. A blood test may be taken to determine the organism causing the infection. In orbital cellulitis, a computerized tomography (CT) scan will be performed; an x-ray of the head is done to identify the extent of any damage.

Complications are:

• Infection of the bone and joint
• Extensive tissue destruction
• Blood poisoning
• Meningitis
• Infection of the lymph vessels

Treatment: Most cases of cellultitis can be treated without hospitalization. When the infection is severe; however, or if the patient is a high risk for severe cellulitis, hospitalization may be necessary. An antibiotic such as penicillin, erythromycin or cloxacillin is given to treat the infection. In severe cases the antibiotic would be given intravenously to prevent complications and to speed up recovery. After 10 days of antibiotic therapy the infection should be cured and the patient no longer at risk. If complications develop a longer course of the antibiotic will be required, and surgery to repair any damage to the tissue.

To relieve the pain, an analgesia such as acetaminophen or advil can be taken. Aspirin will reduce the fever. Rest with elevation of the leg will speed up recovery.

Prevention: Preventive measures include:

• Proper care of wound, cuts and abrasions
• Taking complete course of antibiotics
• Maintaining blood sugar control if a diabetic