Let’s Talk About Cellulitis

At first you以为你想象你的小腿上的红色圆圈。当时它没有打扰你，但现在当你触摸它并且开始膨胀并且甚至可以扩展时，它现在感觉很热，你很肯定有什么东西在那里。你的医生担心它是一种称为蜂窝织炎的细菌皮肤感染，并希望您尽快进入。细胞 - 你 - 什么？这是您需要知道的。

Cellulitis

Our Pro Panel

我们去了一些国家顶级蜂窝织炎专家，为您带来最具科学和最新的信息。

Gina A. Suh, M.D.

Infectious Diseases Specialist

Mayo Clinic

Rochester, MN

Jun Kevin Kang，M.D.

Assistant Professor of Dermatology

Johns Hopkins Medicine

Baltimore, MD

Ohara Aivaz, M.D.

Dermatologist

Cedars-Sinai Dermatology

Los Angeles, CA

无论如何是什么是蜂窝织炎？

Cellulitis is a serious skin infection that occurs when bacteria infect the deep layers of your skin and the tissue beneath it. It is most commonly caused by either链球菌Pyogenes(strep) orStaphylococcus aureus细菌(金黄色葡萄球菌)。然而,它也可以来源于the more serious MRSA (methicillin-resistant Staphylococcus aureus), a type of staph infection that’s become more resistant to antibiotics.

Often, there is some type of cut or break in your skin that allows bacteria to enter, but sometimes there is no such event—or at least none that you can recall. Your skin may be cut or punctured in any number of ways, from a shaving nick to a tattoo or body piercing, or from injection drug use or an animal bite.

Though most people have never heard of cellulitis, it’s not a rare condition. In fact, there are more than 14 million cases of cellulitis in the United States each year. Both men and women can get cellulitis, and it equally affects both genders. And when it comes to age, while you can get cellulitis at any point in your life, it more commonly occurs in those who are middle-aged and older.

An important tidbit: Cellulitis is not commonly passed on to people around you and it's not contagious like a common cold, but you can spread the bacteria to other people (known as a community-acquired infection). Let’s take a closer look at what’s behind this painful condition.

什么Are the Symptoms of Cellulitis?

Cellulitis can show up on any part of the body, but often it develops on a foot or lower leg, places where certain conditions that may make you more susceptible to cellulitis can strike (more on what those are later). It is almost always unilateral, meaning it occurs on just one side of your body. In kids, cellulitis often appears on the face, as this is where they’re more likely to get scratches. The infection tends to occur close to where an initial skin injury took place, if there was one. These are some other common signs of cellulitis:

发红

Cellulitis appears as one area or “sheet” of redness. It may start off at about the size of a quarter on your calf, for instance, and quickly grow to cover your entire lower leg. It is not raised, and there aren’t any spots or dots. It may be circular, but it could also take on other shapes as well.

Warm Skin

当您触摸受影响的地区时，您的皮肤可能会感到温暖。这种热量由您的身体的免疫系统产生，这试图抵御感染。当您触摸受影响的地区时，您也可能会体验温柔或疼痛。

皮肤损坏

Your skin may appear pitted (which can look similar to the uneven, dimpled skin of an orange), and you may develop blisters in the area, too. In cases of severe infection, you will also see pus.

额外症状

Cellulitis can come on suddenly or more gradually, surfacing over several days or weeks and tending to grow redder, more swollen, and more painful with time. It may start off slowly, but once it is there, it may expand quickly. If the red area rapidly expands, your infection may be spreading to other parts of your body. Symptoms that raise the possibility that cellulitis is on the move include:

• Fever

• Chills

• Swollen glands or lymph nodes

• Nausea

什么Are the Risk Factors for Cellulitis?

Pretty much anyone can develop cellulitis and, once you’ve had it, you’re at higher risk for getting it again. This is often because of certain underlying and untreated—or undertreated—conditions you may have that can make you more susceptible to cellulitis. For instance, chronic skin conditions like athlete’s foot andeczemamay help set the stage for cellulitis. Athlete’s foot can cause microscopic tears in the skin that serve as portals of entry for hungry bacteria. With eczema, your skin barrier may be compromised, especially if you scratch, enabling bacteria to enter and cause cellulitis. Chickenpox and/or带状疱疹can increase your chances of developing cellulitis for similar reasons.

Other medical conditions make you more prone to cellulitis:

你有糖尿病

由于各种原因，糖尿病UPS UPS感染风险。例如，如果你不能感到轻微的问题，你可能会在你的脚上开发溃疡，就像神经损伤一样。人们uncontrolled diabetes通常有高血糖，并且没有什么可以吃的比糖多吃。将升高的血糖和开放的伤口放在一起，无人会化，并且您对蜂窝织炎的完美风暴。

You Have Lymphedema

如果您的脚，腿，手和/或手臂由于淋巴米肿块肿胀，您就越容易发生蜂窝织炎。淋巴液在你身体的软组织中堆积起来时会发生淋巴结肿。它通常发生在你的手臂或腿部，并且可以由放射治疗导致淋巴结等癌症手术，以及一些遗传条件。你的淋巴系统应该抵抗感染，但是当它过载时，它不能发生它的工作，可能发生蜂窝织炎等感染。

Your Immune System Is Compromised

This can occur for many reasons, including taking steroid medications,chemotherapy to treat cancer, other medicines that suppress the immune system, and/or certain underlying diseases and conditions. Your risk for infection soars when your immune system isn’t working well. A compromised immune system just can’t do its job as it should, a job that includes fighting off intruders, such as the bacteria that can cause cellulitis, that make their way into the body.

你超重了

Poor circulation in your arms, legs, hands, or feet due to excess weight can cause swelling, which sets the stage for cellulitis. When your skin stretches out, it becomes more prone to cracks and tears, which serve as portals for bacteria to enter.

你有心脏手术

Heart surgery that involves having a vein removed from your leg and reconnecting it to your coronary artery to boost blood flow to your heart may increase your risk of cellulitis if the surgery results in leg swelling.

How Is Cellulitis Diagnosed?

您的医生可能会拍摄小腿上的红色区域，并告诉您是否患有蜂窝织炎。您可能会被要求立即圈出与标记的区域，以了解它在未来是否有任何更大。（你自己这样做不是寻求医学评估的替代品。）

There is no official cellulitis test, so your doctor will ask lots of questions and try to eliminate other diseases that may look like cellulitis. This list of cellulitis imitators includes:

• Herpes infections

• Chronic venous insufficiency(CVI). This vein diseases in your lower leg can mimic the appearance of cellulitis.

• 接触性皮炎。来自过敏或接触性皮炎的皮肤刺激可导致类似于蜂窝织炎的红色斑块。

您可能需要其他测试，例如完整的血统计数，或CBC，看看您的感染是否已开始传播。这种血液测试的一部分，这涉及从你的一只手臂中的静脉中取出少量血液，看着你的白细胞计数。当你生病时，你的免疫系统使用白细胞来抵抗细菌，病毒和其他外国入侵者。所以，当你生病时，你的身体需要产生更多的白血细胞来对抗这些入侵者。CBC中的较高计数白细胞中的白细胞可能表明您的免疫系统正在加班，以抵御感染。

If there is pus at the site of the infection, your doctor may take a culture and send it to a lab. Knowing what type of bacteria you are dealing with can help guide your treatment.

蜂窝织炎并发症

随着蜂窝织炎恶化，细菌进入你的皮肤深层，潜在的血液。没有治疗，感染可以蔓延到你身体的其他区域，即你的血液，关节，骨骼和/或心脏瓣膜的衬里，心脏瓣膜，一种叫心内膜炎的病症。

Although rare, cellulitis may also lead to a very serious infection called necrotizing fasciitis, or flesh-eating bacteria. This is an extreme emergency. Strep bacteria are among蜂窝织炎的最常见原因, and necrotizing fasciitis can happen when the infection is from a very aggressive strep strain called group A streptococcus (GAS). See your doctor ASAP if you experience severe pain and swelling of the affected skin area, or blistering.

Treatment for Cellulitis

If your doctor confirms that you have cellulitis, you will likely be started on oral antibiotics right away, probably a broad-spectrum antibiotic that targets the most common cellulitis culprits. More serious infections—such as those more widespread, those with additional symptoms like high fever and a general feeling of malaise, and those that oral antibiotics have failed to help—may need to be treated in the hospital with intravenous (IV) antibiotics. In these cases, information on what type of bacteria is causing the infection may help your doctor choose the best drug. When the infection is in an arm or leg, keeping the affected limb elevated can help decrease swelling and speed recovery.

When you catch cellulitis early, you will likely recover quickly and fully. You should see improvements in 24 to 48 hours of starting treatment. This means less pain and swelling, and the red area should start to shrink, too.

If you have had multiple bouts of cellulitis as well as risk factors such as lymphedema or diabetes, your doctor may consider putting you on a preventive course of antibiotics to keep repeat infections at bay. The risk and benefits of this practice must be weighed carefully, since overuse of antibiotics can lead to the development of superbugs—bacteria that don’t respond to treatment.

如何预防蜂窝织炎

Unfortunately, cellulitis is not a one-and-done illness. Once you’ve had cellulitis, you have a greater chance of getting it again, especially if you have underlying conditions that predispose you to it. The good news: Following these guidelines can help you minimize your risk of a future infection.

当他们发生时，通过照顾任何和所有皮肤伤口（甚至是轻微剃须的刻痕）开始。清洁所有轻微的切割和伤害，用肥皂和温水打破皮肤，涂抹抗生素软膏，用绷带覆盖直至它们愈合。如果你的伤口深刻​​，如狗咬，请看看你的医生。

When you have a wound, stay away from hot tubs, pools, and natural bodies of water like lakes and rivers, all of which can harbor bacteria that could infiltrate your broken skin barrier and cause another bout of cellulitis.

预防also means taking care of any and all underlying conditions that predispose you to cellulitis. If you have diabetes,check your feet daily for injuries or signs of infection，并确保定期看到脚迪亚斯特医生。保持血糖在正常范围内也很重要。与医生密切合作，以确保您尽可能遵守糖尿病在紧缩的控制下。

If you have had multiple cellulitis infections below the knee, see a doctor to find out if you have athlete’s foot. If you do, treat it to lower the chances that you will develop cellulitis again. This entails topical creams to get the infection under control, along with taking measures to prevent a repeat, including keeping your feet clean and dry and your toenails short and clean so bacteria stay out.
In general, it’s important to moisturize daily to keep your skin barrier intact so that it can do its job and keep bacteria out. If you tend to experience limb swelling, ask your doctor about wearing compression stockings or a leg wrapping to reduce swelling and stave off cellulitis.

Along with these basic DIY prevent methods, these lifestyle changes can also help reduce your risk for repeat bouts of cellulitis:

• Limiting alcohol use, since drinking too much dampens your immune system

• Not smoking

• Maintaining a normal weight

It’s scary to hear that you have cellulitis, but catching it early gives you a true head start on averting some of the potential consequences. Take your antibiotics as directed, and you should start feeling better ASAP. Now that you have had it once, you are at risk for getting it again, so make sure to clean all wounds carefully and stay on top of all underlying conditions that predispose you to cellulitis.

遇见我们的作家

Denise Mann

Denise Mann, MS is a veteran freelance health writer in New York. Her work has appeared on HealthDay, among other outlets. She was awarded the 2004 and 2011 journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery. She was also named the 2011 National Newsmaker of the Year by the Community Anti-Drug Coalitions of America. She's also been awarded the Arthritis Foundation's Northeast Region Prize for Online Journalism, the Excellence in Women's Health Research Journalism Award, the Gold Award for Best Service Journalism from the Magazine Association of the Southeast, a Bronze Award from The American Society of Healthcare Publication Editors, and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Mann has a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill.

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