Cellulitis

Cellulitis

Causes

Group A streptococcus

Staphylococcus aureus.

Predisposing factors

Skin abrasions

Lacerations

Burns

Eczematous skin

Clinical features

Mild cellulitis

• Soft tissue redness
• Warmth and swelling
• Pain/tenderness
• No systemic features
• No significant co-morbidities

Moderate cellulitis

• Above features plus swelling and tenderness
• Systemic features eg fever, tachycardia

Severe cellulitis

• Features above with severe swelling or tenderness
• Large body surface area involved (eg larger than the patient’s handprint)
• Marked systemic features (eg fever or hypothermia, tachycardia, tachypnoea, altered conscious state, unwell appearance, hypotension

Investigations

Swab MCS if there is discharge

Management

Mild cellulitis

Cefalexin 33 mg/kg (max 500 mg) oral tds for 5 days

Moderate cellulitis

Cefalexin 33 mg/kg (max 1 g) oral tds – Max  1gm daily for 5-10 days

Ceftriaxone 50 mg/kg (max 2g) IV daily

Cefazolin 50 mg/kg (max 2g) IV bd

Severe cellulitis

Flucloxacillin 50 mg/kg (max 2 g) IV 6H for 5-10 days