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Management and Treatment of Lower Leg Cellulitis

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What is cellulitis?

Cellulitis is inflammation of the skin and deep tissue beneath the skin. The symptoms are:
• Redness
• Swollen limb
• Tender to touch
• Increased warmth around affected area.
• Blistering

What causes cellulitis?
The cause of cellulitis is one or more types of bacteria that enter through a crack or break in the skin as a possible result of:
• A bruise
• A bump
• Surgical incision
• Wound
• An ulcer
• Athlete’s foot
• Certain insect bites can transmit the bacteria that may cause cellulitis.

Cellulitis usually affects areas on your arms or legs.

What are the Risk Factors?
• Increasing age
• Weakened immune system
• Diabetes
• Chicken pox/shingles
• Swelling

How do I know if my rash is cellulitis?
If you have a rash that’s red, swollen, tender and warm and the area affected is getting bigger, try to see your doctor as soon as possible. It is important to identify and treat cellulitis early. If necessary your doctor may take either a sample of tissue from the affected area or a sample of blood. The results of either of these tests should identify the bacteria causing the infection. As the symptoms for cellulitis are similar to a deep vein thrombosis (blood clot), your doctor may also ask for further tests to be done to rule this out.

If you experience:
• Chest pain
• Breathlessness
You should contact your GP without delay or go to your nearest A & E department. These symptoms could indicate a more serious problem that would need more specialist treatment.

What is the treatment for cellulitis?
Treatment will depend on how severe the infection is, treatment usually involves either antibiotics given by mouth (orally) or intravenously (by injection or infusion (drip) into a vein (usually your
arm).

Will I have to come into hospital?
Cellulitis can usually be treated successfully with oral antibiotics at home. The infection may seem only superficial, but sometimes it can affect the tissue underlying the skin and spread to your
lymph nodes and bloodstream. If there are signs that the cellulitis is more complicated, treatment may require hospital admission for the first doses of antibiotics to be given intravenously (IV).
Our OPAT team can give an initial dose of intravenous antibiotic in hospital (if you are well enough to go home) and then District Nurses will administer subsequent intravenous antibiotics and
monitor the area affected. Usually after a few days of having your medicine intravenously you can continue medication by a tablet that you can swallow (oral antibiotic).

For longer courses of antibiotics our OPAT team can teach either you or a relative to administer the antibiotics. If you live in an area outside the area covered by our local district nurse service
you can return to the hospital daily for intravenous medication administration.

Is there anything I can do to help to prevent cellulitis?
Yes, you can:
• Keep your skin clean and well-moisturised.
• Keep your hand and toe nails short and clean.
• Treat fungal infections of hands and feet early.

If you have swelling in the leg, rest often and raise the limb so that it is above the level of your body when sitting or lying.

Further information locally:
OPAT through switchboard ask for bleep 1234.
Acute Medical Unit:
01908996578
• District Nurse
• Family Doctor (GP)
• Practice Nurse
Milton Keynes Urgent Care Centre
Telephone: 01908 303030
www.miltonkeynesurgentcare.co.uk

References can be supplied for the information contained within this leaflet from the author.