What Causes Cellulitis?

Cellulitis is a common bacterial infection that affects the skin and the soft tissue underneath. It occurs when bacteria, most often streptococcus or staphylococcus, enters through a break in the skin. Cellulitis causes swelling, redness, pain and warmth, and can affect nearly all parts of the body. In adults, signs of cellulitis are most common on the skin of the lower legs. If left untreated, cellulitis can spread to the lymph nodes and bloodstream and become life-threatening.

Signs of cellulitis can usually be observed around the damaged area of skin where the infection began. Wounds in areas with poor circulation, and those that have not been cleaned sufficiently, are more likely to result in cellulitis. The most common cellulitis symptoms — redness, swelling and tenderness — present on the skin itself, but some people may also experience other symptoms of an infection, including fatigue, chills, cold sweats, shivering, fever and nausea. Cellulitis blisters, lethargy, drowsiness and red streaks may indicate that the infection is spreading.

Orbital cellulitis is an infection of the fat and muscles around the eye. It is a serious condition that can lead to blindness if not treated immediately.

Orbital cellulitis symptoms may include:

  • Painful swelling of upper and lower eyelids
  • Bulging eyes
  • Decreased or double vision
  • Pain when moving the eye
  • Fever
  • Difficult eye movements
  • Shiny, red or purple eyelids

Cellulitis is relatively common, affecting approximately 14.5 million people in the United States, and there are quite a few factors that may increase a person’s risk of developing the infection, including:

  • Age — children and the elderly are more susceptible to cellulitis
  • Obesity
  • Leg issues
  • Previous or recurrent cellulitis
  • Exposure to environmental factors
  • Skin conditions that cause breaks in the skin
  • Lymphedema
  • Diabetes
  • Weakened immune system
  • Circulatory problems
  • Recent surgery or injury
  • Intravenous drug use

Symptoms of Cellulitis

There are several skin conditions — erysipelas, dermatitis and abscesses — that share many of the signs and symptoms of cellulitis, which can sometimes lead to misdiagnosis. Like cellulitis, erysipelas is caused by bacteria getting into the body through an open spot in the skin, but the appearance of the infected area is usually different. One of the most distinctive cellulitis symptoms is a raised border around the rash that makes it stand out from the skin around it. Abscesses, also caused by bacteria getting into the body, share some cellulitis symptoms but are characterized by lumps under the skin. Though dermatitis can sometimes look like a cellulitis rash, it is not caused by bacteria and is treated with creams and antihistamines rather than antibiotics.

In most cases, doctors will be able to make an accurate diagnosis simply by looking at the cellulitis symptoms, but they may sometimes suggest blood tests or biopsies to rule out other possible conditions.

Cellulitis Complications

In most cases, signs and symptoms of cellulitis disappear within several days after the patient begins an antibiotic regimen, but serious complications are possible, including:

  • Permanent swelling Recurrent cellulitis may damage the lymphatic drainage system and cause chronic swelling of the affected area.
  • Blood infection and sepsis If left untreated, the bacteria that caused cellulitis can get into the bloodstream and lead to sepsis, a serious and life-threatening condition.
  • Infection in other regions – The bacteria that caused cellulitis can infect other parts of the body, including muscles, bones or heart valves. This cellulitis complication is rare but requires immediate medical treatment.

Cellulitis complications can be very serious and can cause long-term damage like tissue death, amputation, shock or even death. To avoid complications, alleviate cellulitis symptoms, and minimize the risk of recurrent cellulitis, it is critical for people to seek medical attention if they see any signs of cellulitis.

What Is the Best Path to Cellulitis Recovery

Most cases of cellulitis are treated quickly and effectively with antibiotics, but cellulitis complications and recurrent cellulitis may require more comprehensive care. At Kindred Hospitals we have an interdisciplinary team of physicians and nurses who specialize in treating infectious diseases like cellulitis and work together to develop treatment plans that prevent further complications and facilitate recovery. Treatments may include antibiotic or antiviral medication, wound care and physical rehabilitation, among other services.

“Cellulitis can be a very painful and scary disease, especially when it presents in conjunction with other conditions,” says Dr. Sean Muldoon, Senior Vice President and Chief Medical Officer of Kindred Healthcare's Hospital Division. “The interdisciplinary team at Kindred specializes in these types of medically complex scenarios and works together to create a treatment plan that alleviates painful cellulitis symptoms, eliminates the underlying cause, and prevents dangerous complications.”


Success Spotlight: Kenneth’s Story

Kenneth fell in the bathroom and had to be taken to the hospital, where his condition rapidly deteriorated and he had to be placed on a ventilator. Additional complications presented even greater challenges to overcome, including septic shock brought on by cellulitis and pneumonia. Unable to take anything by mouth, Kenneth had to be given a feeding tube as well and he remained at the general hospital until he had been stabilized and was ready to be transferred to Kindred Hospital for respiratory therapy and rehabilitation.

Right from the start Kenneth was very motivated, even though he experienced a few setbacks along the way. His respiratory therapists worked with him to strengthen his lungs and successfully liberated him from the ventilator. Kenneth was also assisted by his speech pathologist to relearn how to swallow and use his voice again after the breathing tube was removed. His nurses, assistants and physicians oversaw his recovery from cellulitis and pneumonia and administered medical care. His physical and occupational therapists helped Kenneth begin to regain his independence through strengthening and mobility exercises, and by the time he was discharged from Kindred Kenneth was back up on his feet, able to walk with a rolling walker and gaining more strength and mobility every day.

“I have really enjoyed my stay,” Kenneth shared before he left Kindred. “I came here with one foot in the grave and my team got me back on track – thank you all! I especially am grateful to Rebecca and Ling in respiratory as well as Lewis and Allen, Molly and Theresa, and Thomas who always stopped by to see how I’m doing and always took the time to make things fun. As good as a hospital can be, this one is really the best.”