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<div class="noeditbox">Welcome to &lt;a href="Pathophysiology of Complex Patient Problems"&gt;PT 635 Pathophysiology of Complex Patient Problems&lt;/a&gt; This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div><div class="editorbox">
<div class="noeditbox">Welcome to [[Pathophysiology of Complex Patient Problems|PT 635 Pathophysiology of Complex Patient Problems]] This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div><div class="editorbox">
'''Original Editors '''- &lt;a href="Pathophysiology of Complex Patient Problems"&gt;Students from Bellarmine University's&nbsp;Pathophysiology of Complex Patient Problems project.&lt;/a&gt;
'''Original Editors '''- [[Pathophysiology of Complex Patient Problems|Students from Bellarmine University's&nbsp;Pathophysiology of Complex Patient Problems project.]]


'''Top Contributors''' - &lt;img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="1" _fck_mw_template="true"&gt; &nbsp;  
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} &nbsp;  
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</div>  
== Definition/Description  ==
== Definition/Description  ==


Cellulitis is a localized bacterial skin infection, which typically affects the lower limbs but can occur on any area of skin and underlying subcutaneous tissue.<sup>1,2</sup>&nbsp;It is characterized by acute onset of redness, inflammation, pain, and swelling of the affected area. Accompanying symptoms include generalized fever, rigors, nausea, and vomiting.<sup>1&nbsp;</sup>The infection is most commonly caused by B-Hemolytic Streptococci bacteria and reoccurs up to 50% of the time in the lower extremity.<sup>1,3</sup> Most individuals diagnosed with cellulitis have a low risk of severe complications but few suffers can have severe sepsis, local gangrene, and/or necrotising fasciitis.<sup>1 </sup><br>
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== Prevalence  ==
== Prevalence  ==


*650,000 hospital admissions per year in the United States are due to Cellulitis.<sup>5</sup>
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*When hospitalized, patients with recurrent cellulitis require longer hospitalizations relative to nonrelapsing Cellulitis patients.<sup>5</sup>
*From 1998-2006, 10% of all infectious-disease hospitalizations were related to Cellulitis<sup>5</sup><sup></sup>
*22-49% of patients who have cellulitis report at least one previous episode<sup>5</sup>
*Recurrences, typically in the same location, occur approximately 14% of cellulitis cases within 1 year and in 45% of cases within 3 years<sup>5</sup><br><br>


== Characteristics/Clinical Presentation  ==
== Characteristics/Clinical Presentation  ==


Typical symptoms include acute poorly demarcated and spreading erythema along with pain, swelling, and warmth of the lower extremity but can occur on any area of skin or underlying subcutaneous tissue.<sup>2,3</sup>&nbsp; Additional symptoms may include fever, nausea, vomiting, and rigors.<sup>3,10</sup> Other features include proximal dilated and edematous skin lymphatics and bulla formation.<sup>3</sup> Cellulitis predominantly has a unilateral presentation.<sup>3</sup><br>  
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== Associated Co-morbidities  ==
== Associated Co-morbidities  ==
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<h2> Medications  </h2>
== Medications  ==
<p>Cephalexin, Dicloxacillin, Penicillin VK, Amoxicillin, and Clindamycin are typical Antistreptococcal Antimicrobial agents for the treatment of typical cellulits that is considered mild and does not show signs of systemic involvement.<sup>3 &nbsp;</sup>Figure 1 states which medications would be appropriate based on the severity of symptoms and the risk of&nbsp;Methicillin-resistant Staphylococcus aureus (MRSA).<sup>4</sup><br />
</p><p><br />
</p>
<table width="200" border="1" cellpadding="1" cellspacing="1" summary="*Vancomycin is the drug of choice for infections resulting from MRSA">


<tr>
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<th scope="col"> <u>Clinical Presentation</u>
</th><th scope="col"> <u></u><u>Appropriate Antibiotic Treatment</u>
</th></tr>
<tr>
<td> Routine Cellulitis with low suspicion of MRSA
</td><td> Dicloxacillin, Cephalexin, Nafcillin, or Cefazolin
</td></tr>
<tr>
<td> High suspicion of MRSA or Penicillin allergy
</td><td> Doxycycline, Clindamycin, Trimethoprim-sulfamethoxazole
</td></tr>
<tr>
<td> High suspicion of MRSA with signs and symptoms of severe infection or did not respond to initial routine treatment
</td><td> Vancomycin*, Linezolid
</td></tr></table>
<ul><li>Vancomycin is the drug of choice for infections resulting from MRSA<sup>4</sup>
</li></ul>
<p><sup></sup>
</p>


== Diagnostic Tests/Lab Tests/Lab Values  ==
== Diagnostic Tests/Lab Tests/Lab Values  ==
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== Medical Management (current best evidence)  ==
== Medical Management (current best evidence)  ==


Currently, there are no published national guidelines for the treatment of cellulitis.<sup>5 </sup>Most common management of the infection is administration of antibiotics. In more severe cases of cellulitis, intravenous antibiotics can be used.<sup>8</sup> Elevation and compression of the affected area promotes drainage of edema and can reduce inflammation, speeding up recovery.<sup>8</sup>
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For those with recurrent cellulitis, prophylactic antibiotic therapy is an option. Recent studies show that antibiotic prophylaxis substantially reduced the number or recurrences experienced by patients while actively taking the medication. Although there is reduction during the antibiotic therapy, there is no evidence of persistent protect effect after it has ceased.<sup>1</sup>
 
<sup></sup>In regards to those patients with recurrent cellulitis due to lymphedema, decongestive therapy including manipulation of the lymphatic system through massage, has shown to reduce the recurrence of cellulitis.<sup>9</sup><sup></sup>
 
<sup></sup>


== Physical Therapy Management (current best evidence)  ==
== Physical Therapy Management (current best evidence)  ==
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== Case Reports/ Case Studies  ==
== Case Reports/ Case Studies  ==


add links to case studies here (case studies should be added on new pages using the &lt;a href="Template:Case Study"&gt;case study template&lt;/a&gt;)<br>  
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br>  


== Resources <br>  ==
== Resources <br>  ==
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== Recent Related Research (from &lt;a href="http://www.ncbi.nlm.nih.gov/pubmed/"&gt;Pubmed&lt;/a&gt;)  ==
see tutorial on &lt;a href="Adding PubMed Feed"&gt;Adding PubMed Feed&lt;/a&gt;
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== References  ==
== References  ==


see &lt;a href="Adding References"&gt;adding references tutorial&lt;/a&gt;.  
see [[Adding References|adding references tutorial]].  


&lt;span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /&gt;
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&lt;a _fcknotitle="true" href="Category:Bellarmine_Student_Project"&gt;Bellarmine_Student_Project&lt;/a&gt;
[[Category:Bellarmine_Student_Project]]

Latest revision as of 02:04, 17 June 2019

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.

Top Contributors - Victoria Loving, Kacie McClendon, Admin, Erica Shelley, Elaine Lonnemann, James Chad Cissell, Tony Lowe, Jason Larimore, Olivia Tefera, Wendy Walker and Kim Jackson  

Definition/Description[edit source]

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Prevalence[edit source]

add text here

Characteristics/Clinical Presentation[edit source]

add text here

Associated Co-morbidities[edit source]

add text here

Medications[edit source]

add text here

Diagnostic Tests/Lab Tests/Lab Values[edit source]

add text here

Etiology/Causes[edit source]

add text here

Systemic Involvement[edit source]

add text here

Medical Management (current best evidence)[edit source]

add text here

Physical Therapy Management (current best evidence)[edit source]

add text here

Differential Diagnosis[edit source]

add text here

Case Reports/ Case Studies[edit source]

add links to case studies here (case studies should be added on new pages using the case study template)

Resources
[edit source]

add appropriate resources here

References[edit source]

see adding references tutorial.


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