“Ouch, my leg hurts, Din!”cried my father in-law. His fiery red and swollen calf immediately caught my eyes. He was shivering.
“What happened, Dad?”I rushed to him. His skin felt warm. Fever. “This is cellulitis, Dad”I instantly made a spot diagnosis. I was sure of my diagnosis, since it is a condition that is very frequently referred to us in the Department of Orthopaedics, so much so that it has become our bread and butter.
Cellulitis is caused by bacterial infection of the skin, usually by Staphylococcus aureusor Streptococcus species. The infection can occur after a trauma caused by sharp object, insect bites, wounds or even infection that has spread from other organs.
The infected skin will become red, warm and swollen. Patients will have high fever and won’t be able to walk due to the pain on the affected limb.
Treatment
If you are experiencing any of the above symptoms, you need to go to the hospital immediately. We need to ensure that the infection is only confined to the skin, and has not spread to the deeper layers such as the fascia or muscles. This serious infection is called necrotizing fasciitis and might lead to death if not treated soon enough.
Cellulitis can be treated with intravenous antibiotics in which the antibiotics will be administered through the patient’s veins. You will need to rest in the hospital for a few days until the infection has been eliminated. The swelling on your leg will subside faster if you elevate your leg higher than the level of your heart and walk less during treatment.
When the swelling has subsided, the skin of your leg will appear wrinkled, a condition we call “wrinkle sign”. It means that the infection has been successfully eliminated and you can be discharged home.
This article was written by one of Malaysian Medical Gazette’s permanent columnist, Dr. Mahyuddin, an orthopaedic surgeon who is currently working in a hospital in Pahang. Get to know him more from The Team’s page. This article was translated from https://www.mmgazette.com/cellulitis-jangkitan-pada-lapisan-kulit-dr-ahmad-mahyuddin/ by Dr Aini Hanan Azmi.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]