
Cellulitis
What is cellulitis?
It is normal to have some inflammation (redness and swelling) around a wound as it heals. Inflammation and cellulitis are different. Cellulitis is an infection of the skin and tissues under the skin that is caused by bacteria. Group A streptococcus and staphylococcus aureus bacteria live on the skin and are the most common types of bacteria that cause cellulitis. Openings in the skin, such as cuts, scrapes, sores, insect bites or stings, injuries, and surgery incisions may easily become infected with these bacteria. The symptoms of cellulitis spread very fast and may include redness, pain, warmth, fever, and swelling of the skin. The swelling may give the skin a dimpled or “orange peel” appearance. Cellulitis can quickly worsen into a more severe infection. Signs of worsening infection may include swollen lymph nodes, tiredness, sweating and chills, muscle aches, nausea and vomiting, or a high fever.
What can I expect in the hospital?
You may need to stay in the hospital because you are very sick or you need treatment that must be done in the hospital. You also may have a medical condition that is making your wound infection worse or could cause added complications, such as diabetes,
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
Monitoring
- You will be checked often by the hospital staff.
- Your heart rate, blood pressure, and temperature will be checked regularly.
Testing
Testing may include:
- Fluid or pus at the edge of the infected area may be sent to the lab and tested. If you have an infection, it may take several days to find out what kind of bacteria is causing it. Knowing which bacteria are causing the infection helps your provider choose the right treatment.
- Blood tests to check for infection in the blood or how well your infection is responding to treatment.
- Tests to look for infection in the tissue or bone.
Treatment
The treatment for cellulitis depends on the bacteria that caused the infection, your symptoms, how well you respond to treatment, your overall health, and any complications you may have.
- You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
- You may have a dressing put over the wound to protect it or to help absorb fluid that is draining from the wound.
- You may have a tight wrap, called a compression dressing, put around the area to reduce swelling.
- The area of the body with the wound will be raised or propped up with pillows.
- Your provider may need to do surgery to remove infected tissue. This is called debridement.
- Your provider may prescribe medicine to:
- Treat pain
- Treat the infection
What can I do to help?
- You will need to tell your healthcare team if you have new or worsening:
- Signs of worsening infection. These include:
- The area of skin is more red, tight, or painful.
- The area of skin is very warm to touch.
- You have blood, pus, or other fluid coming from any open area of your skin.
- You have a fever higher than 101.5° F (38.6° C).
- You have chills or muscle aches.
- Swollen lymph nodes (glands)
- Signs of worsening infection. These include:
- Ask questions about any medicine, treatment, or information that you do not understand.
How long will I be in the hospital?
How long you stay the hospital depends on many factors. The average amount of time to stay in the hospital with cellulitis is 3 to 4 days.
If your wound infection is severe and you need additional treatment, you may stay in the hospital longer. You may need to go to a nursing facility to continue your wound care program before going home.
Last modified: 2014-07-30
Last reviewed: 2014-07-31
Cellulitis: References
Goldman, L, & Schafer, A. (2011). Goldman’s Cecil medicine [24th ed.]. Retrieved from http://www.mdconsult.com/.
Rosen, P., & Marx, J. A. (2014). Rosen’s emergency medicine: concepts and clinical practice. (8th ed.). Philadelphia: Elsevier Saunders.
Mandell, G, Bennett, J, & Dolin, R. (2010). Mandell, Douglas, and Bennett’s principles and practice of infectious diseases [7th ed.]. Retrieved from http://www.mdconsult.com/.
Rakel, R. & Rakel, D. (2011). Textbook of family medicine. [8th ed.]. Retrieved from http://www.mdconsult.com/.
World Health Organization (undated). Prevention and management of wound infection: Guidance from WHO’s Department of Violence and Injury Prevention and Disability and the Department of Essential Health Technologies. Retrieved from http://www.who.int/hac/techguidance/tools/Prevention%20and%20management%20of%20wound%20infection.pdf.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp