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Connective Tissue- Cellulitis

Introduction

The human skin acts as a protective barrier for the body by surrounding internal

organs and maintaining homeostasis by absorbing and secreting moisture and sweat. It is made of three distinct layers: 1) epidermis, 2) dermis, and 3) subcutaneous layer. The dermis of the skin is made up of a papillary layer that has loose connective tissue and a reticular layer, made up of dense irregular connective tissue. The papillary has thin collagen and elastic fibers whereas the reticular layer is less cellular and has thicker irregular bundles of type I collagen fibers and coarser elastic fibers. These give the skin its elasticity. The subcutaneous layer, also made up of loose connective tissue, has fat cells called adipocytes that store energy and provide a cushion to the organs underneath the skin.

Discussion

Cellulitis is an infection of the dermis and the subcutaneous fat layer below as bacteria enters a break in the skin and spreads thereof. Streptococcus and Staphylococcus are the two most common types of bacteria that cause this. These bacteria can enter through broken or be transmitted through an insect bite. People with flaky and dry skin are more likely to get an infection. It can present itself on any part of the skin, although it is commonly seen on the legs. It usually follows with redness, swelling, inflammation, and occasionally leaking of yellow fluid or pus. In severe cases, fever, nausea/vomiting, enlarging or hardening of the red spot or increased pain is observed. Most commonly, a doctor will conduct a physical exam and order tests such as blood work or bacteria culture to confirm the diagnosis. The blood work will notify the clinician whether or not the infection has spread to the blood.

Because it spreads quickly, it is important to catch it early on before it spreads to the lymph nodes and blood, as cellulitis can be fatal.

Because it spreads quickly, it is important to catch it early on before it spreads to

Fig. 1. Histology shows a marked eosinophil infiltration in the dermis. Flame figures are seen (haematoxylin and eosin, ×200 (inset ×400)). SOURCE: “Medical Journals”

Treatment Plan

The patient is advised to rest the area, elevate the infected region in order to reduce swelling, and take a course of oral antibiotics for about 7-14 days. Additionally, taking over-the-counter pain medication such as ibuprofen or acetaminophen to help with the pain and fever. However, based on the severity of the infection or it spread, the patient maybe given IV antibiotics, intramuscular antibiotics or IV antibiotics with hospitalization, respectively. In rare cases, fluid build-up may need to be drained and any dead tissue found will need to be removed surgically. For future prevention, I would advise the patient to maintain good hygiene and clean any cuts or breaks of the skin with soap and water. A good practice would be to make sure that the patient wears shoes when outdoors and regularly inspects skin for cuts that stay inflamed for longer than a week. Applying an antibacterial ointment would also help prevent future infections.

Literature Cited

  • 1. "Cellulitis Symptoms, Causes, Treatments, & More." WebMD.

  • 2. Hei Sung Kim, Min Ju Kang, Hyung-Ok Kim, and Young Min Park. "ContentEosinophilic Cellulitis in a Patient with Gastric Cancer." Eosinophilic Cellulitis in a Patient with Gastric Cancer.

  • 3. Ross, Michael H., Lynn J. Romrell, and Gordon I. Kaye. Histology: A Text and Atlas. Baltimore: Williams & Wilkins, 1995. Print.