Cellulitis can be mistaken for a number of
common lower limb conditions, including
varicose eczema, lipodermatosclerosis, gout
and deep vein thrombosis (DVT), so it is
important that healthcare professionals can
differentiate between the various conditions
and commence the most appropriate treatment.
Cellulitis of the lower limb can be identified
by redness, heat, pain and swelling of (usually)
one leg. The patient may have influenza-like
symptoms and will feel unwell and feverish with
possible rigors. The area of erythema will have
developed suddenly, with rapid spreading, and
will be tender to touch. The area affected will be
well demarcated. Blistering may be present with
possible leakage of serous exudate from the
swollen limb, causing risk of maceration and
possible ulceration. The entry site of the
infection may not be obvious, but tinea pedis,
insect bites or any minor injuries may act as
a portal of entry for bacteria. The patient’s
white cell count and C-reactive protein levels
will be markedly raised (the number of white
cells, especially neutrophils, increases when a
clinical infection is present; C-reactive protein
levels in the blood rise when an area of soft
tissue is inflamed) (Beldon 2011)