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Cellulitis is a common clinical problem. Cellulitis is an acute inflammatory condition of the skin, generally caused by infection. The typical characteristic features of Cellulitis are localized pain, erythema (redness), swelling, and heat at the area of inflammation.

Causative agents of Cellulitis:

Cellulitis can be caused by indigenous flora which colonizes the skin and appendages like Staphylococcus aureus and Streptococcus. Pyogenes. Other species of staphylococcus and streptococcus also cause cellulites. It can also be caused by variety of other exogenous organisms, mainly bacteria like Pseudomonus aeruginosa, Pasteurella multocida (commonly cat bite and less commonly dog bite), Capnocytophaga canimorsus, Eikenella corrodens, Aeromonas hydrophila etc.

Route of entry of causative organism in Cellulitis:

Bacteria generally gain access to the epidermis through cracks in the skin, which is mainly due to abrasions, cuts, burns, insect bites, surgical incisions, and intravenous catheters. Different organisms gain entry by different routes, e.g. cellulitis caused by S. aureus spreads from a central localized infection, like an abscess (folliculitis), or from an infected foreign body like a splinter, a prosthetic device, or an intravenous catheter.

Diagnosis of cellulites:

Due to the involvement of exogenous bacteria in cellulites, a thorough history including epidemiologic data can provides important clues to the infecting organism. Whenever possible, a Gram’s stain and culture of the pus which is collected during drainage can provide a definitive diagnosis. If pus can not be cultured or Gram’s stain can not be done, it is very difficult to establish a diagnosis due to the similarity of the clinical features in staphylococcus and streptococcus cellulitis. Even with needle aspiration of the leading edge or a punch biopsy of the cellulitis tissue itself, cultures are positive in only 20% of cases, which suggest only small numbers of bacteria cause cellulites. The expanding area of redness within the skin may be a direct effect of extra-cellular toxins or due to the soluble mediators of inflammation.

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Posted by - June 25, 2009 at 11:42 pm

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