High-risk problems: Infectious cellulitis

Cellulite is one of those conditions that we can consider easy to treat but very high risk if not treated correctly or ignored. So even though it is a disease with a very good prognosis, the patient cannot omit care, or he could lose his life .

Infectious cellulitis , as it is actually called, has nothing to do with aesthetic cellulite, which does not carry any fatal health risks. Although their name is the same, their realities are very different.

In this article we are going to go into detail about the disease to explain it in the best possible way.

• What is it?
• Why does it occur?
• Where do these bacteria come from?
• In what parts of the body is it produced?
• Risk factor's
• Why is it so serious?
• Complications
• How is it treated?
• Recommendations

What is infectious cellulitis?

Infectious cellulitis is an acute bacterial infection of the connective tissue of the dermis and subcutaneous layer of the skin , characterized by inflammation, redness, pain and often an increase in local temperature, i.e. what is known as phlogosis.

Technically, infectious cellulitis involves several pathological and microbiological processes:

• Bacterial invasion : The infection is commonly caused by gram-positive bacteria, particularly Streptococcus pyogenes and Staphylococcus aureus .
• Immune response and inflammation : Once bacteria invade tissue, the immune system responds, causing an inflammatory cascade. Leukocytes, primarily neutrophils, are attracted to the site of infection, releasing enzymes and cytokines that result in the classic clinical signs of cellulitis: flushing (redness), heat, swelling (swelling), and pain.
• Spread and edema : Inflammation increases vascular permeability, leading to extravasation of fluids and cells into the subcutaneous tissue, causing edema. The spread of infection can be facilitated by bacterial enzymes such as hyaluronidases and proteases.

Why does it occur?

As explained in the previous section, cellulitis is a bacterial infection that is caused by the presence of Streptococcus pyogenes or Staphylococcus aureus on the surface of the skin. On healthy skin, these pathogens do not pose any problem, but there are A break in the skin barrier, such as a wound, abrasion, burn, insect bite or injection, these bacteria move through the wound, overcome the epidermis and lodge in the subcutaneous layers of the skin, where they begin to infect the tissue. connective and spread.

Where do these bacteria come from?

Streptococcus pyogenes is a NON- saprophytic bacteria, which indicates that it is not part of the bacteria present in a healthy human body. This bacteria is spread by contact with other humans through direct contact, wounds or droplets from breathing or sneezing. It can also be spread through contaminated utensils, food or by breathing in poorly ventilated and humid environments. When it enters the body through breathing it causes infections in the upper respiratory tract, such as pharyngitis, but when it stays on our skin, it can create cellulitis if a wound occurs. The best way to prevent cellulite from occurring is with good personal hygiene, especially hand washing.

Staphylococcus aureus is a saprophytic bacteria, that is, we all have it naturally in the human body, on the surface of our skin, so we do not have to look for a way to eliminate it. To prevent cellulitis from occurring, it is best to disinfect the wound as soon as it occurs or clean the healthy skin with alcohol or another disinfectant before drawing blood, injecting medication or getting a tattoo.

In what parts of the body is it produced?

Infectious cellulitis can occur in any part of the body where a wound occurs, although there are some areas more common than others, although more for circumstantial reasons than for the disease itself.

• Lower limbs: Especially in the lower part of the legs . This is one of the most common areas due to increased exposure to injury and blood circulation that may be less efficient in these areas, especially in older people or those with certain medical conditions, which will be detailed later.

• Face: Cellulite on the face can be particularly concerning due to its proximity to the brain and vital structures.

• Arms and hands: Although less common than the legs, infections in the arms and hands can occur, especially in people with a compromised immune system .

• Thoracic and abdominal area: Although less common, cellulite can develop in the torso and abdomen, particularly in people with obesity or recent surgeries.

Risk factor's

• People with poor circulation in the legs, such as those with diabetes or peripheral artery disease , are at higher risk of serious complications, as the infection may be harder to control.

• Infections around the eyes (periorbital cellulitis) or in the deep tissues of the cheek (facial cellulitis) need immediate medical attention, due to the proximity of the blood vessels to the brain and lymph nodes.

• People with compromised immune systems , such as those with HIV/AIDS, diabetes, on immunosuppressant treatment, oncology patients or splenectomized patients (removal of the spleen), have a high probability of complications if they develop cellulitis.

• Parts of the body with lymphedema or chronic edema are more prone to infections and are more difficult to treat, since they have compromised lymphatic circulation, which causes a weak immune response and that makes it difficult to detect the infection (weak immune response -> less obvious symptoms -> later detection of the infection) and facilitates the rapid spread of the infection to other parts of the body.

Why is it so serious?

Cellulite is a condition that heals quickly and easily when treated at the beginning of the infection, with the first symptoms , but if it is not treated quickly or medical indications are not strictly followed, it can have very serious consequences for your health. :

Rapid spread : This infection can spread rapidly through the skin tissue and underlying layers, affecting large areas in a short time. If left untreated, the infection can spread to the lymph system and bloodstream.

Potential for severe complications : Infectious cellulitis can lead to serious complications such as septicemia (infection in the blood), abscesses (collections of pus), tissue necrosis (tissue death), or necrotizing fasciitis (a rapid and severe infection of tissue that can destroy muscle, fat and skin tissue).

Risk in vulnerable people: People with weakened immune systems, diabetes, peripheral vascular diseases, obesity, or chronic edema have a higher risk of developing serious complications from infectious cellulitis.

Long-term consequences as it can cause permanent tissue damage, which can lead to chronic problems such as lymphedema (swelling due to the accumulation of lymphatic fluid).

Growing antibiotic resistance can make treatment more complicated and less effective, increasing the risk of complications.

Complications

Of all the possible complications of cellulite, there are two that are especially serious. Sepsis or septicemia and necrotizing fasciitis .

Sepsis occurs when the infection reaches the bloodstream and spreads throughout the body, as it begins to cause organ failure, the body responds in an unregulated manner to the infection by not being able to fight all the sources and if Not controlled immediately can cause the death of the patient. It also increases blood pressure which could cause cardiovascular accidents in the heart or brain.

Necrotizing fasciitis is a serious and rapidly progressive bacterial infection that affects the connective tissue that covers the muscles, nerves, fats, blood vessels and fascia. This disease, often called "flesh-eating disease," is very serious and to prevent it from causing fatal sepsis, it may require surgery to remove the necrotic tissues, which in the case of extremities, could be amputated.

How is it treated?

Treatment of infectious cellulitis usually begins with the administration of antibiotics to combat the bacterial infection. The choice of antibiotic depends on several factors, including the type of bacteria suspected of causing the infection, the severity of the infection, and whether the patient has allergies to certain medications. In mild to moderate cases, oral antibiotics are usually sufficient and are given over a period of 7 to 14 days. It is crucial to complete the full course of antibiotics to ensure that the infection is completely eliminated. Additionally, elevating the affected area may be recommended to reduce swelling and pain, and rest is advised to speed recovery.

In more severe cases or in patients who do not respond to oral therapy, hospitalization for intravenous antibiotics may be necessary. Monitoring and treating potential complications are also important. In some situations, surgical intervention may be necessary, especially if there are signs of abscess (buildup of pus) or tissue necrosis. Wound care and proper follow-up are essential to ensure healing and prevent recurrence. Additionally, for patients with risk factors such as diabetes or poor circulation, management of these underlying conditions is vital to avoid future infections and associated complications.

Recommendations

Here is a list of recommendations in case you suffer from infectious cellulitis.

1. Seek medical attention as soon as you notice the signs and symptoms of cellulite, such as redness, swelling, warmth, and pain in an area of ​​skin. Do not delay in seeking help, as early treatment can prevent complications.
2. If you are prescribed antibiotics , be sure to take them exactly as directed and complete the entire course of treatment, even if your symptoms improve before you finish.
3. Follow the wound care instructions given to you by your doctor. This includes cleaning it properly and keeping it covered, if necessary.
4. Elevating the infected area above the level of the heart can help reduce swelling and pain.
5. Complete rest : Rest and avoiding physical activity will help speed up recovery.
6. Monitor symptoms and seek immediate medical attention if the infection appears to worsen, if you develop a high fever, if symptoms spread quickly, or if you experience nausea, vomiting, or confusion.
7. If you have conditions that increase your risk of cellulite, such as diabetes or poor circulation, be sure to manage these conditions effectively.
8. Maintain good hygiene , especially regular hand washing, to prevent the spread of infection.
9. Do not self-medicate or use home remedies without first consulting a health professional.
10. Follow up with your doctor to make sure the infection has completely resolved, remember that even if the symptoms disappear, the infection may still be present.

Finally, remember that early detection and treatment turns this serious condition into something almost anecdotal.