Eukaryotic Infectious Diseases- Cellulitis
Cellulitis is a eukaryotic infection characterized by a non-necrotizing inflammation of subcutaneous tissues and the skin following acute infection (Brown & Hood, 2022). There has to be a breach or invasion in the skin for cellulitis to occur. Patients diagnosed with non-purulent cellulitis usually present with warm skin, pain, swelling, and erythema. A physical examination reveals bullae, violaceous color, and infected skin. Patients diagnosed with severe cellulitis usually present with circumferential cellulitis, fever, chills, fatigue, toxicity, lymphangitic spread, and pain. Risk factors for severe and recurrent cellulitis include increased age, diabetes, immunodeficiency, kidney disease, liver disease, and cancer. Cellulitis organisms in immunocompromised patients include Enterobacter, Citrobacter, Pseudomonas proteus, and Helicobacter cinaedi (Brown & Hood, 2022). Do you need help with your assignment ? Contact us.
Evaluation is done through patient history, physical examination, imaging, histology, and biopsy. The patient’s history must include any cases of trauma, pain scale, disease progression, skin disorders such as fungal infections, past medical history, HIV status, and surgical history (Brown & Hood, 2022). The physical examination is initially conducted on the affected area to categorize the type of cellulitis, identify the pathogen involved and determine the severity of infection. Cellulitis without abscess, penetrating trauma, or underlying drainage is caused by Staphylococcus aureus. A blood culture is performed in severe cellulitis to determine the organism involved and rule out methicillin-resistant Staphylococcus aureus. A complete blood culture count is recommended to show leukocytosis and leukopenia in severe cellulitis. Needle aspiration is done in immunocompromised and diabetic patients with neutropenia, cellulitis with bullae, animal bites, and poor response to empiric therapy. Gram stain and culture are done before incision and drainage of an abscess. Patients who suffer from extensive cellulitis with non-viable tissue are subjected to histology and managed using debridement. The histology findings usually reveal clusters of neutrophils invading the adipose tissue, hemorrhagic fat, and necrotic bright yellow fat (Brown & Hood, 2022).
Cellulitis is treated using antibiotics (Brown & Hood, 2022). Cellulitis with an isolated abscess with little tissue involvement can be treated through drainage without administering antibiotics. Cellulitis without abscess is treated using amoxicillin or cephalexin. Patients with penicillin allergy are treated using clarithromycin, clindamycin, or erythromycin. An initial dose of a parenteral antibiotic such as ceftriaxone can be administered, followed by oral medications. Fluoroquinolones such as levofloxacin are avoided in cellulitis due to their high susceptibility to resistance. Patients with recurrent cellulitis are managed using amoxicillin, penicillin G, or erythromycin. In case of a topical fungal infection, systemic antifungals such as fluconazole and topical antifungals such as clotrimazole are administered. Severe cellulitis is treated using parenteral medications such as ceftriaxone, oxacillin, and cefazoline. Patients who are allergic to penicillin are treated using parenteral vancomycin or clindamycin. Treatment of cellulitis with severe abscess formation is complicated by methicillin-resistant Staphylococcus aureus (MRSA); therefore, an empiric regimen must target MRSA until a culture is done (Siddiqui & Koirala, 2022). Patients who experience gas in the tissue, skin sloughing, violaceous bullae, rapid disease progression, cutaneous haemorrhage, and hypotension are scheduled for emergency surgical evaluation
Treatment of cellulitis using antibiotics is highly effective. A timely start of therapy increases its effectiveness. In patients with recurrent cellulitis, constant and continuous treatment with antibiotics might lead to antibiotic resistance (Habboush & Guzman, 2022). Physicians, nurses, and other healthcare workers should treat cellulitis with no abscess and little tissue involvement by drainage only without administering antibiotics to prevent antibiotic resistance (Shrestha et al., 2022).
References
Brown, B.D., & Hood Watson, K.L. (2021). Cellulitis. StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549770/
Habboush, Y., & Guzman, N. (2022). Antibiotic Resistance. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513277/
Shrestha, J., Zahra, F., & Cannady, Jr P. (2021). Antimicrobial Stewardship. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK572068/
Siddiqui, A.H, & Koirala, J. (2022). Methicillin-Resistant Staphylococcus Aureus. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482221/
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Question 
Pick one of the eukaryotic infectious diseases found in Chapter 16. (could be MRSA skin and soft tissue infection, Impetigo or cellulitis infection)
Eukaryotic Infectious Diseases- Cellulitis
In a two-page paper, identify and describe the nature of your chosen eukaryotic infectious disease.
Research and include the type of medication used to treat it.
Include what the medication will attempt to target.
Based on valid research, include your opinion on the effectiveness of the medication in stopping the infection.