Necrotizing cellulitis is an infection that spreads under the skin and affects the skin itself, as well as the fat underneath. In most cases, the infection begins when an area of broken skin – such as from a cut, puncture wound or even a surgical incision – is exposed to bacteria. Occasionally a fungus is responsible for the infection, but bacteria are the most common culprits. Cellulitis infections are most common on the legs, arms and face, and facial infections are most common in infants. Among children infected with facial cellulitis about 1 in 12 cases lease to meningitis.
Cellulitis occurs in three different forms:
Periorbital cellulitis – infection around the eye sockets
Erysipelas – identifed by raised, firm, bright red patches of skin and caused by Streptococcus bacteria
Necrotizing fasciitis – an infection that occurs below the skin’s surface in the connective tissues
Rarely cellulitis can start on skin that hasn’t been broken, but this is mainly found in people who have weakened immune systems, those with diabetes or people taking corticosteroids.
Symptoms of Cellulitis
Cellulitis most often begins in a small area of skin on the lower leg, but the arms, hands, feet and groin are other possible sites for infection. Early symptoms include:
- skin that is red, glossy, painful and warm to the touch
- skin that is not smooth, but raised, and may be completely separated from the layer beneath by a pocket of gas created by the bacteria
- fever (which may appear one or two days before the skin rash)
- impaired vision (in cases where the infection is around the socket of the eye)
If the infection travels into the lymphatic system or the bloodstream red lines may be seen under the skin before the main rash appears. When this occurs you may also see symptoms like:
In many cases the doctor is able to diagnose cellulitis simply by looking at the patient’s skin.
Treatment of Cellulitis
Shriners Hospitals for Children® offers treatment for cellulitis based on the severity of the infection, the site of infection and how far the disease has spread. Uncomplicated cases of cellulitis are treated with a variety of antibiotics. Other treatment may include:
- bed rest or restricted movement of the affected body part
- elevating the affected area
- warm compresses
In cases of necrotizing cellulitis the infected flesh must be surgically removed. In the most severe cases, amputation may be required to prevent the spread of the disease.