Leg Cellulitis

While skin infections can occur anywhere on the body, leg cellulitis is by far the most prevalent and potentially dangerous condition. By definition, cellulitis (Erysipelas) is a spreading bacterial infection (of the staphylococcus or Group A streptococcus variety) of the cells in the connective tissue below the skin. Known as “cellulitis of the extremities,” it can affect people of all ages. In children under three, leg cellulitis may occur with exposure to Haemophilus influenzae type B.  

According to recent national medical statistics, skin and soft tissue infections are on the rise. Visits to emergency rooms, doctor’s offices and outpatient clinics have increased from 32 - 48%, the number of reported cases reaching 14.2 million by 2005. Of those, cellulitis and abscess accounted for 95% of the increased visits. The United Kingdom reports what they term a “three-fold” increased incidence of treatment for the same conditions.

Symptoms include swelling, redness, tenderness and pain which are caused not only by the infection itself, but by the body’s attempts to fight it off.  As the infection progresses, the skin may become hot, and pus-filled blisters may appear.

The person suffering the infection may start to experience fever, chills, headache, swollen lymph glands, and low blood pressure. In extreme cases, especially if the infection is not treated, it can spread to the lymph glands, and initiate sepsis by way of the blood stream.

Causes of infection may include cuts or breaks in the skin, boils, burns, blisters, scrapes, animal or insect bites, athlete’s foot, dermatitis, injection sites or puncture wounds. Risk of infection is also higher among diabetics, users of cortisone drugs, those with compromised immune systems, pregnant women, and those previously infected with cellulitis.

Other risk factors include, but are not limited to, patients suffering from:

Vein problems
Skin conditions such as eczema and psoriasis
Diabetic skin ulcers
Lymphatic system disorders
Surgical wounds

Treatment of leg cellulitis varies, depending on the severity of the disease. In most cases, a physician’s inspection of the infected area will suffice. A 10-day dose of antibiotics such as cephalexin will be prescribed, symptoms normally disappearing after three or four days.

Intravenous antibiotics may be administered if the patient is suffering from a high fever or other effects of advanced infection. Tissue or blood samples may be gathered if the doctor has any doubts about the nature or progress of the infection. If there is a suspicion of deep vein thrombosis (whose symptoms mimic those of cellulitis), the doctor may perform specialized tests.

In rare instances, infection can cause clotting of small blood vessels, after which the surrounding tissue will start dying- representing an extreme medical emergency. Denied the benefit of antibodies and white blood cells (which were carried by the now-destroyed blood vessels), more infected tissue dies and the infection spreads rapidly to surrounding areas.

If the dead tissue is not removed and the infection stopped, damage will spread deeper to the muscle surface (the fascial lining), and across the skin, possibly resulting in amputation and death. For this reason alone, those suffering from leg cellulitis should always seek prompt medical attention.

In extreme cases, hyperbaric oxygen therapy may be beneficial, due to its ability to forcibly increase oxygen presence in body tissues.

Following the requisite medical treatment, warm water soaks, bed rest and elevation of the leg will help ease discomfort and promote healing.

Statistics show that 50% of those afflicted with leg cellulitis will suffer from it again in the future. As such, it is vital that the attending physician follow up with recovering leg cellulitis patients about lifestyle changes that might mitigate the chances of recurrence. Recommendations may include changes to medications, dietary restrictions, and improved personal hygiene.