Unit 5.3 Cellulitis

CELLULITIS

Overview

  • Cellulitis is a common skin infection that affects the dermis and subcutaneous tissues.

PATHOPHYSIOLOGY AND ETIOLOGY

  • Entry:

    • Normal flora (bacteria) gain entry into the dermis, leading to an infection.

  • Symptoms:

    • Inflammation, erythema (redness), pain, warmth, and edema (swelling) are observed.

    • Possible presence of vesicles (fluid-filled lesions).

  • Common Pathogens:

    • Most often caused by Staphylococcus and Streptococcus species.

    • Haemophilus influenzae may also be involved.

    • Methicillin-resistant Staphylococcus aureus (MRSA) is a concern, especially in close living quarters such as:

    • Dormitories,

    • Prisons,

    • Hospitals,

    • Healthcare residential settings.

COMMON RISK FACTORS

  • Children:

    • Trauma, impetigo (a bacterial skin infection), folliculitis, untreated tooth decay, recent otitis media (middle ear infection).

  • Older Adults:

    • Thinner skin makes them more susceptible to breakage and injury.

  • Medical Conditions:

    • Illnesses and conditions that increase susceptibility to infection, such as:

    • Diabetes,

    • Lymphatic obstruction.

  • Skin Integrity:

    • Any interruption of skin integrity increases risk.

  • Fungal Infections:

    • Tinea pedis (athlete’s foot) can also be a risk factor.

NURSING ASSESSMENT

  • Infection Recognition:

    • Recognize infection signs and any ongoing changes in the patient’s condition.

  • Documentation:

    • Thorough documentation of findings is crucial.

    • "A picture is worth a thousand words" - visual documentation can be beneficial.

  • Monitoring:

    • Marking the borders of the infected area can help track any changes in size.

    • Regular monitoring of vital signs is essential.

TREATMENTS

  • Medications:

    • Administer prescribed antibiotics according to medical guidelines.

  • Supportive Care:

    • Warm compresses, applied 4 times a day (QID).

    • Elevation of the affected limb to reduce swelling.

    • Bed rest to promote recovery.

  • Patient Advisories:

    • Alert patients about possible complications, including:

    • Abscess formation,

    • Fever (temperature ≥ 101°F),

    • Increased lethargy.

    • Teach patients when to contact their healthcare provider, particularly if:

    • The infected area shows any signs of spreading or worsening.

PATIENT EDUCATION

  • General Care:

    • Maintain good nutrition to support the immune system.

    • Practice handwashing and proper handling and disposal of dressings to prevent spread.

    • Avoid sharing linens or towels; wash clothing and linens in hot water.

    • Do not squeeze or open lesions to prevent secondary infections.

  • Hygiene Practices:

    • Avoid plucking nasal hair or picking the nose to minimize entry points for bacteria.

    • Complete the full course of antibiotics as prescribed to ensure effective treatment.

    • Bathe daily with antibacterial soap to reduce bacterial load on the skin.

    • Apply warm compresses to lesions twice to four times a day (bid to qid).

PERIORBITAL CELLULITIS

  • Related to infections such as Staphylococcus.

  • Can manifest as:

    • Abscesses and boils,

    • Cellulitis in the periorbital region (around the eyes).

ADDITIONAL CONDITIONS

  • Associated skin infections include:

    • Folliculitis,

    • Impetigo.

REFERENCES

  • Cleveland Clinic 2021.

  • Further studies and guidelines may be needed for comprehensive understanding and updates in treatment protocols.