A cellulitis is an infection of the soft tissue. This type of infection is much different from osteomyelitis, which is an infection of the bone. A cellulitis of the foot or lower leg is usually red, hot, swollen, and tender. A classic description of cellulitis is "red streaking" leading up the foot or leg. Patients that are immunocompromized or have weak immune systems are more likely to suffer from cellulitic episodes. A cellulitic foot or leg can be very painful and can cause the patient a great deal of disability. If a cellulitis is not properly and aggressively treated, the infection may spread quickly through the surrounding tissues and become even more serious requiring more aggressive treatment.
A cellulitic infection can be caused by a number of factors. A "streptococcus" organism is the most common cause of cellulitis in the lower extremity. In diabetics we many times see mixed infections causing cellulites. These means that there are more than just one organism. Some patients are more susceptible to cellulitic infections and have frequent flare-ups of this localized soft tissue involvement. In cases of recurrent cellulitic episodes, the lymph nodes can become scarred from the infection and will become activated when the patient suffers from a stressful or traumatic event. A small break in the skin, an ulceration, or an infected toenail may lead to cellulitis. Poor hygiene may also predispose one to a cellulitic infection as well as diabetes mellitus.
Cellulitic infections are usually treated with antibiotics. Since cellulitis is caused by a particular organism, an antibiotic is the standard of care. Occasionally, when the infection is not localized and seems to be spreading aggressively, an oral antibiotic may not be sufficient and IV antibiotics are then used. Sometimes if an abscessed area exists it must be treated to let the antibiotics get to the infected area. The major complaints by the patient with a localized cellulitis are most often pain and swelling. Therefore, elevation of the foot/leg is very important as is sufficient pain control. Patient and doctor observation is another crucial factor in the management of this condition. If a patient suffers from foot ulcerations or has breaks in the skin, a careful ongoing monitoring program is needed to prevent the spread of the infection.