Cellulitis Essay

Published: 2021-07-13 18:45:07
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Category: Medical

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IntroductionCellulitis is a skin infection caused by bacteria Staphylococcus aureus particularly when the physical skin barrier, the immune system and the circulatory system are impaired. It manifest itself in the human skin as reddish, swollen and tender parts. The disease is devastating and easily spread across the human body hence making it painful. The largely affected part of the human body is the lower limbs though other areas are not exception. It both affects the overlying and minimally the subcutaneous tissues of the skin. The bloodstream and the lymph nodes are not exempted though this is witnessed only at the advanced level of the disease. If not well managed the disease can become lethal.Incidence and PrevalenceStudies reveal that the incidence rate of cellulitis is 24.1/1000 persons a year. Males of approximately all ages are usually vulnerable and show high risk of contracting the disease. The incidence rate increases with increase in age. It is also evident from the research studies that 78% of cellulitis cases were reported to receive treatment in outpatient set ups. This is a considerable higher incident rate in comparison with population based studies. Less than 20% of the patients studied developed the disease again and also required care in a period of 28 days and above. Studies also reveals that the lower extremity is the common site of the disorder in both gender. The study used in assessing the incidence and prevalence included equal number of both gender in a age range of 0-64 years. The population had both sick and healthy individuals. Though the insurance claims has some limitations, it was used to evaluate the prevalence rates. The limitations associated with insurance claims includes data entry errors as well as over or underreporting.PathophysiologyCellulitis is associated with the infestation of the staphylococcus aureus bacteria. The most common forms of the bacteria that are pathogenic include the Group A Streptococcus and Staphylococcus. This bacteria is harmless and is usually found on the skin surface. It is only harmful when the skin surface is broken and the bacteria gains access to the subcutaneous layer and the dermis. Conditions such as insect and animal bites, recent surgery, athlete foot, burns and dry skin usually predisposes the skin for the cellulitis. The bacteria then becomes an antigen to the body since it is foreign. The body reacts to the foreign body by causing swelling, pain, redness and itching. These are the results of the body inflammatory response to kill the foreign body. In case the cellulitis spread to the fascial lining it causes necrotizing fasciitis. This may result to an immediate medical emergency.Physical Assessment and ExaminationThe physical assessment and examination of cellulitis is majorly based on the morphology of the lesion as well as the clinical setting. The diagnosis is more accurate and improved with the help of the dermatologists. The symptoms of the disease are swelling and redness of the disease, swollen glands in the affected area. The physician is expected to mark the edges of the redness with a pen. This is to evaluate if the redness surpass the boundary marked over the days. The patient may be questioned about other dermatological disorders in particular those caused by fungus. He or she should let the physician know of other comorbid conditions. These may be risk factors to cellulitis and the most reknown ones are human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS), diabetes, chronic liver disease and the diabetes. Edema and impaired lymphatic drainage are also some of the predisposing factors to leg cellulitis. The leg is usually the most vulnerable site of cellulitis infection.Treatment Plan and Patient EducationTreatment plan includes antibiotic regimens. This has been found effective in more than 90% of the patients. Drainage may be employed in the cases of the abscesses. Drainage is seen to suffice in absence of the antibiotics. This only applies in case the abscess is relatively isolated. Methicillin-resistant Staphylococcus aureus and macrolide or erythromycin-resistant Streptococcus pyogenes usually complicates the treatment of the disease. Less severe cases of cellulitis are treated with semisynthetic penicillin such as first and second order cephalosporin, clindamycin and macrolides. Beta-lactam antibiotic therapy is used in the treatment of the cellulitis that do not need the draining of the abscess. Parenteral therapy is used in cases of severe cellulitis. Though the disease is not contagious the patients are expected to keep high levels of hygiene. They are expected to wash their hands regularly with soap and water and also not to share towels. They are also expected to keep the wound clean and dry.Follow up and Evaluation of the Treatment PlanEarly treatment positive response is a clear indicator of drug efficacy. However, the disease is indolent since the edema and inflammation has a prolonged time to clear. The ultimate determination of absolute cure or failure to cure relies on the global assessment of the course of the illness. Adjunctive measures such as compression and elevation that may result to improvement within two days may not predict ultimate cure. Therefore, early follow up may result to false positive results.\ReferencesQuirke, M. etl (2017). Risk factors for non-purulent leg cellulitis: a systematic review and meta‐analysis. British Journal of Dermatology, 177(2), 382-394.Quirke, M. etl (2015). Prevalence and predictors of initial oral antibiotic treatment failure in adult emergency department patients with cellulitis: a pilot study. BMJ open, 5(6), e008150.Raff, A. B., & Kroshinsky, D. (2016). Cellulitis: a review. Jama, 316(3), 325-337.

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