Template:PCPP

Welcome to <a href="Pathophysiology of Complex Patient Problems">PT 635 Pathophysiology of Complex Patient Problems</a> 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 - <a href="Pathophysiology of Complex Patient Problems">Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.</a>

Top Contributors - <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">  

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.^1,2 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.¹ The infection is most commonly caused by B-Hemolytic Streptococci bacteria and reoccurs up to 50% of the time in the lower extremity.^1,3 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.¹

Prevalence

• 650,000 hospital admissions per year in the United States are due to Cellulitis.⁵
• When hospitalized, patients with recurrent cellulitis require longer hospitalizations relative to nonrelapsing Cellulitis patients.⁵
• From 1998-2006, 10% of all infectious-disease hospitalizations were related to Cellulitis⁵
• 22-49% of patients who have cellulitis report at least one previous episode⁵
• Recurrences, typically in the same location, occur approximately 14% of cellulitis cases within 1 year and in 45% of cases within 3 years⁵
  
  

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.^2,3  Additional symptoms may include fever, nausea, vomiting, and rigors.^3,10 Other features include proximal dilated and edematous skin lymphatics and bulla formation.³ Cellulitis predominantly has a unilateral presentation.³

Associated Co-morbidities

add text here

Medications

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.³  Figure 1 states which medications would be appropriate based on the severity of symptoms and the risk of Methicillin-resistant Staphylococcus aureus (MRSA).⁴

Clinical Presentation	Appropriate Antibiotic Treatment
Routine Cellulitis with low suspicion of MRSA	Dicloxacillin, Cephalexin, Nafcillin, or Cefazolin
High suspicion of MRSA or Penicillin allergy	Doxycycline, Clindamycin, Trimethoprim-sulfamethoxazole
High suspicion of MRSA with signs and symptoms of severe infection or did not respond to initial routine treatment	Vancomycin*, Linezolid

• Vancomycin is the drug of choice for infections resulting from MRSA⁴

Diagnostic Tests/Lab Tests/Lab Values

add text here

Etiology/Causes

add text here

Systemic Involvement

add text here

Medical Management (current best evidence)

add text here

Physical Therapy Management (current best evidence)

add text here

Differential Diagnosis

add text here

Case Reports/ Case Studies

add links to case studies here (case studies should be added on new pages using the <a href="Template:Case Study">case study template</a>)

Resources

add appropriate resources here

Recent Related Research (from <a href="http://www.ncbi.nlm.nih.gov/pubmed/">Pubmed</a>)

see tutorial on <a href="Adding PubMed Feed">Adding PubMed Feed</a>

addfeedhere|charset=UTF-8|short|max=10

References

see <a href="Adding References">adding references tutorial</a>.

<span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" />

<a _fcknotitle="true" href="Category:Bellarmine_Student_Project">Bellarmine_Student_Project</a>