Cellulitis is a sudden, non-contagious infection of the skin, characterised by redness, swelling, and heat, accompanied by pain and tenderness. People with lymphoedema are particularly susceptible to cellulitis because the lymphatic system is damaged or overloaded and does not function adequately to fight infection. What does it present like and what do we do about it?

The presence of chronic lymphoedema can predispose to recurrent episodes of cellulitis. The relationship between cellulitis and lymphoedema is a vicious cycle where each episode of cellulitis further damages the lymphatic system, leading to a degree of secondary lymphoedema (lymphoedema caused by external sources, i.e., infection or surgery), which in turn constitutes an increased risk for cellulitis

How do you get Cellulitis?

Cellulitis usually occurs when certain types of bacteria enter into damaged, broken down, or inflamed areas of skin. Causes may include some of the following:

Trauma such as, an insect bite, burn, abrasion or cut.

A surgical wound.

Skin problems such as, eczema, psoriasis, acne, or tinea

A foreign object in the skin, such as metal or glass.

What are the signs of Cellulitis in Lymphoedema?

Often the first sign of cellulitis is increased pain or tenderness of the lymphoedema limb or body part, often similar to ‘flu-like’ symptoms or aching involving that limb. Following this is usually a sudden onset of an area of redness, blotches, or red streaks, or rash on the skin of the involved limb. These tissues become warm/hot, swollen and tender. The skin may look tight and glossy. The person with cellulitis may also develop a high fever, chills, sweats, shaking, and a general malaise (ill feeling). The area of redness can spread rapidly as the cellulitis worsens.

What should you do if you think you have Cellulitis?

PROMPT treatment with oral antibiotics will resolve the cellulitis usually within a minimum of 10 – 14 days. Seek medical attention at the first signs of an acute attack of cellulitis as your medical doctor can prescribe antibiotics and assess your symptoms. STOP current lymphoedema treatment, including massage and compression during this acute phase, until you speak to your therapist. Rest the affected limb. It is vital to diagnose and treat cellulitis early, as left untreated, severe cases can spread the infection to the rest of the body. Severe cellulitis may require antibiotics intravenously (via a drip) in hospital.

Holly Chance, Occupational Therapist