Cellulitis

Definition

Cellulitis is an acute bacterial infection of the deep dermis and subcutaneous tissue, most commonly caused by Streptococcus pyogenes or Staphylococcus aureus (including MRSA). It spreads rapidly and can progress to sepsis or necrotizing fasciitis if untreated.

Clinical Features

• Warm, red, tender, swollen skin with poorly demarcated borders
• Fever, chills, malaise
• Lymphangitic streaking (red streaks toward lymph nodes)
• Regional lymphadenopathy

Risk Factors

Breaks in skin (cuts, insect bites, ulcers), diabetes, peripheral vascular disease, immunosuppression, lymphedema, obesity, and IV drug use.

Nursing Interventions

Mark the border with pen to monitor progression, elevate the affected extremity, apply warm compresses, and administer IV or oral antibiotics as ordered. Educate patients to complete the full antibiotic course. Monitor for sepsis and necrotizing fasciitis. Severe pain disproportionate to findings is a red flag.

NCLEX Relevance

Mark the border and elevate the extremity. Recognize signs of systemic spread.