Management of Cellulitis Discussion Essay

CELLULITIS

Cellulitis is a commonly known skin infection that occurs as a result of bacterial translocation through a break in the skin. The skin serves as a primary defensive mechanism of the body by preventing bacterial from reaching the inner layers of the skin, subcutaneous tissue and lymphatic system. When the skin integrity is breached either by skin injuries, surgical incisions, intravenous site punctures, or animal bites, the bacteria gains access into this structures, resulting to either an acute superficial infection affecting the dermis causing Erysipelas or deep skin structures and the subcutaneous tissue, causing Cellulitis;  others population at risk of cellulitis are people with comorbidities such as diabetes mellitus, venous insufficiency and peripheral arterial disease.  Group A beta-hemolytic streptococcus (Streptococcus pyogenes) is the commonly common isolated bacteria in cellulitis. (Brown and Hood 2022) Management of Cellulitis Discussion Essay

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Cellulitis is most common in lower extremities. Rrapi Chand and Kroshinsky (2021) describes it as a disease that present with  reddening, raised local temperature, swelling, pain, fever and lassitude as a hallmark of cytokine and neutrophil response to bacteria breaching the epidermis. The cytokines and neutrophils are recruited to the affected area after bacteria have penetrated the skin for production of antimicrobial peptides and keratinocyte proliferation and trying to limit the spread of the infection to one area.

Informed health origination (2018) informs that cellulitis can be diagnosed by APRNS from a detailed clinical history and evaluation with laboratory testing rarely needed for bacteriology and sensitivity test when the injury is from an animal bite, history of recent injury or scratch usually is pathagnomical of cellulitis.

Santer and co (2018) found out that patient with mild infection without sighs of systemic involvement oral antibiotic covering Group A streptococcus for five days will suffice, while  patient with purulent cellulitis, methicillin-resistant staph aureus colonization, cellulitis with an abscess or extensive wounds, or a history of intravenous drug use, these patient should receive antibiotics that cover against methicillin-resistant staph aureus,  Immune-compromised patient, patient with systemic signs of infection, have failed outpatient treatment, patient exhibiting rapidly progressing erythema, or have cellulitis overlying or near an indwelling medical device benefits from hospitalization and administration of systemic antimicrobials. Management of Cellulitis Discussion Essay
REFERENCES

Brown D, Hood L. Cellulitis.  [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549770/.

Rrapi R, Chand S, Kroshinsky D. Cellulitis: A Review of Pathogenesis, Diagnosis, and Management. Med Clin North Am. 2021 Jul;105(4):723-735. doi: 10.1016/j.mcna.2021.04.009. PMID: 34059247.

InformedHealth.org  [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2018-. Erysipelas and cellulitis: Overview. [Updated 2018 Feb 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK303996/

Santer M, Lalonde A, Francis A, Smart P, Hooper J, Teasdale E, Del Mar C, Chalmers R, Thomas S. Management of cellulitis: current practice and research questions. Br J Gen Pract. 2018 Dec;68(677):595-596. doi: 10.3399/bjgp18X700181. PMID: 30498163; PMCID: PMC6255235. Management of Cellulitis Discussion Essay