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2014-15

BIOLOGY
INVESTIGATORY PROJECT

A.JAYVARDAN
KV NO.2, Jalahalli
East,Bangalore.

What Is Cellulites?
Cellulitis is a bacterial infection involving the skin. It specifically
affects the dermis and subcutaneous fat. Signs and symptoms include an area
of redness which increases in size over a couple of days. The borders of the
area of redness are generally not sharp and the skin may be swollen. While
the redness often turns white when pressure is applied this is not always the
case. The area of infection is usually painful. Lymphatic vessels may
occasionally be involved and the person may have a fever and feel tired. The
legs and face are the most common site involved, though cellulitis can occur on
any part of the body. The leg is typically affected following a break in the
skin. Other risk factors include obesity, leg swelling, and old age. For face
infections a break in the skin beforehand is not usually
the case. The bacteria most commonly involved are
streptococci and Staphylococcus aureus. In contrast
to cellulitis, erysipelas is a bacterial infection involving
the more superficial layers of the skin, presents with an
area of redness with well-defined edges, and more
often is associated with fever. More serious infections
such as an underlying bone infection or necrotizing
fasciitis should be ruled out. Diagnosis is usually
based on the presenting signs and symptoms with cell
culture rarely being possible. Treatment with antibiotics
taken by mouth such as cephalexin, amoxicillin or cloxacillin is often used. In
those who are seriously allergic to penicillin, erythromycin or clindamycin may
be used. When methicillin-resistant Staphylococcus aureus (MRSA) is a concern
doxycycline
or
Trimethoprim/sulfamethoxazole
may,
in
addition,
be
recommended. Concern is related to the presence of pus or previous MRSA
infections. Steroids may speed recovery in those on antibiotics. Raising the
infected area may be useful as may pain killers. Around 95% of people are
better after seven to ten days of treatment. Potential complications include
abscess formation. Skin infections affect about 2 out of every 1000 people
per year. Cellulitis in 2010 resulted in about 27,000 deaths worldwide that
year. In the United Kingdom cellulitis was the reason for 1.6% of admissions
to the hospital.

Symptoms
Possible signs and symptoms of cellulitis include:
Redness
Swelling
Tenderness
Pain
Warmth
Fever
The changes in your skin may be accompanied by a fever. Over time, the
area of redness tends to expand. Small red spots may appear on top of
the reddened skin, and less commonly, small blisters may form and burst.

When to see a doctor:


It's important to identify and treat cellulitis early because the condition
can cause a serious infection by spreading rapidly throughout your body.

Seek emergency care if:


You have a red, swollen, tender rash or a rash that's changing rapidly
You have a fever

See your doctor, preferably that day, if:


You have a rash that's red, swollen, tender and warm and it's
expanding but without fever.

INFECTED LEFT SHIN IN COMPARISON TO SHIN WITH NO SIGN


OF SYMPTOMS

Causes
Cellulitis occurs when one or more types of bacteria enter through a
crack or break in your skin. The two most common types of bacteria that
are causes of cellulitis are streptococcus and staphylococcus. The
incidence of a more serious staphylococcus infection called methicillinresistant Staphylococcus aureus (MRSA) is increasing.

STREPTOCOCCUS

STAPHYLOCOCCUS

Although cellulitis can occur anywhere on your body, the most common
location is the lower leg. Bacteria is most likely to enter disrupted areas
of skin, such as where you've had recent surgery, cuts, puncture wounds,
an ulcer, athlete's foot or dermatitis.
Certain types of insect or spider bites also can transmit the bacteria
that start the infection. Areas of dry, flaky skin also can be an entry
point for bacteria, as can swollen skin.
.
Predisposing conditions for cellulitis include insect or spider bite,
blistering, animal bite, tattoos, pruritic (itchy) skin rash, recent surgery,
athlete's foot, dry skin, eczema, injecting drugs (especially subcutaneous
or intramuscular injection or where an attempted intravenous injection
"misses" or blows the vein), pregnancy, diabetes and obesity, which can
affect circulation, as well as burns and boils, though there is debate as
to whether minor foot lesions contribute.

Tests And Diagnosis


The appearance of your skin will help your doctor make a diagnosis.
Your doctor may also suggest blood tests, a
wound culture or other tests to help rule
out a blood clot deep in the vein of your legs.
Cellulitis in the lower leg is characterized by
signs and symptoms that may be similar to
those of a clot occurring deep in the veins,
such as warmth, pain and swelling.
Lyme
disease
can
be
misdiagnosed
as
staphylococcal-or
streptococcal-induced cellulitis. Because the characteristic bullseye
rash does not always appear in patients infected with Lyme disease,
the similar set of symptoms may be misdiagnosed as cellulitis.
Standard treatments for cellulitis are not sufficient for curing Lyme
disease. The only way to rule out Lyme disease is with a blood test,
which is recommended during warm months in areas where the
disease is endemic.

Treatments And Drugs


Cellulitis treatment usually is a prescription oral antibiotic. Within
three days of starting an antibiotic, let your doctor know whether
the infection is responding to treatment. You'll need to take the
antibiotic for up to 14 days. In most cases, signs and symptoms of
cellulitis disappear after a few days.
If they don't clear up, if they're
extensive or if you have a high fever,
you may need to be hospitalized and
receive antibiotics through your veins (intravenously).
Usually, doctors prescribe a drug that's effective against both
streptococci and staphylococci. Your doctor will choose an antibiotic
based on your circumstances. No matter what type of antibiotic
your doctor prescribes, it's important that you take the medication
as directed and that you finish the entire course of medication,
even if you start feeling better.
Your doctor also might recommend elevating the affected area,
which may speed recovery.