Cellulitis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S.

Cellulitis can be complicated by the development of sepsis, osteomyelitis, lymphangitis, endocarditis, meningitis, and gangrene. The prognosis of cellulitis is good provided the patient starts on an antibiotic treatment regimen.

Cuts and wounds on the skin are the most common means of contracting cellulitis. Other conditions may also lead to the condition. Staphylococcus aureus and Group A Streptococci are the most common causative agents of infection. When the bacteria invades the skin, they release toxins which cause local erythema, pain, and induration. With a course of oral antibiotic treatment, cellulitis can be cured.^[1] Cellulitis spreads fairly fast, and if the disease is not treated it can lead to multiple serious complications.

Cellulitis can be complicated by the development of:

• Blood infection (sepsis)
• Bone infection (osteomyelitis)
• Inflammation of the lymph vessels (lymphangitis)
• Inflammation of the heart (endocarditis)
• Meningitis
• Shock
• Tissue death (gangrene)

Cellulitis usually subsides within 7-10 days of antibiotic use.^[2] Longer treatment may be needed if the cellulitis is more severe. This may occur if the patient has a chronic disease or their immune system is not working properly. People with fungal infections of the feet may have cellulitis that keeps recurring. The cracks in the skin from the fungal infection allow bacterial entry into the skin.

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