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Medical Dermatology Conditions

Bacterial Skin Infections

Bacterial skin infections are a common condition affecting the skin. It usually affects hospitalized patients and people with an underdeveloped or weak immune system, such as children, the elderly, and the immunocompromised.

The skin is said to be the largest organ in the body, and it functions to protect the internal organs from harmful microorganisms and harsh environments. Aside from this function, the skin also regulates body temperature and is involved with sensation. The skin is made up of three layers: the epidermis or the outer, waterproof layer; the dermis, which is made up of connective tissue, sweat glands and hair follicles; and the subcutaneous layer which is made up of fat and some connective tissues. If there is a breach in the epidermis, microorganisms can enter the dermis and, in less common cases, the subcutaneous layer. This results to a skin infection.

Common Causes

Bacterial skin infections develop upon entry of bacteria into the skin. The most common bacteria that cause them are Streptococci and Staphylococci. These bacteria may enter the body through recent surgery, cuts, puncture wounds, ulcers, fungal infections, or skin inflammation. For young children, Hemophilus influenza bacteria may cause skin infections in the face, arms, and upper torso. Pasteurella multocida bacteria may cause skin infections from a dog or cat bite or scratch. Aeromonas hydrophilia and Vibrio vulnificus are the most common bacteria that cause skin infections after exposure to freshwater or seawater. In a punctured wound, cellulitis may be caused by Pseudomonas aeruginosa.

Types of Bacterial Skin Infections

The most common bacterial skin infections are cellulitis, impetigo and folliculitis.

1. Cellulitis is the most common among the three and is a more serious bacterial skin infection. Often, it affects the skin of the lower legs, but may also appear in the face and in any part of a person’s body. In more serious cases, it will penetrate the deeper layers of the skin and continue to spread in the lymph nodes and to the bloodstream. This condition may be life-threatening. Hence, a consultation with a medical practitioner must be done as early as possible.

2. Impetigo usually occurs in infants and children in the form of a red rash which in many cases oozes and forms a yellowish crust on its surface1. These lesions typically occur around the nose and mouth but can also spread to other parts of the body.

3. Folliculitis is an infection of the hair follicles brought about by bacteria, viruses, fungi and inflammation2. It can manifest as small bumps on the surface of the skin, with a yellowish, reddish or whitish color. These may form crusts on the surface and can be painful, tender and bring about itchiness.

Cellulitis – General Symptoms and Manifestation

Generally, anybody who has cellulitis may experience pain and tenderness in the affected area, redness or inflammation of the skin, a skin sore or rash that proliferates, tight, glossy, swollen skin, a feeling of warmth in the affected area, and an abscess with pus and fever. For severe cases, other symptoms may be observed, such as shaking, chills, feeling ill, fatigue, dizziness, lightheadedness, muscle aches, warm skin, and sweating. If cellulitis continues to develop, the patient may experience drowsiness, lethargy, blisters, and red streaks. These are common signs that cellulitis is spreading.

Cellulitis can range from mild to severe cases. A person may have a higher risk of acquiring cellulitis due to some factors like a cut, scrape, or other injuries to the skin, a weakened immune system, skin conditions that cause breaks in the skin, such as eczema and athlete’s foot, IV drug use, diabetes, having a history of cellulitis, swelling of your arms or legs (lymphedema) and obesity. Complications of this condition include severe tissue damage (gangrene), amputation, damage to internal organs that become infected, shock, and worst, death.

Types of Cellulitis and their Specific Symptoms

Various types of cellulitis affect the multiple parts of a person’s body. Periorbital cellulitis is a severe infection that causes inflammation of the skin and tissue surrounding the eye. It develops in the surface of the eyelid to the bony cavity of the face. Symptoms include swelling of the upper and lower eyelid, redness of the upper and lower eyelid, pain, fever, general discomfort of the eye.

Facial cellulitis usually develops around the eyes, nose, and cheeks. Often, it is associated with a dental condition (odontogenic). Its symptoms include fever, chills, malaise, and a limited desire to drink fluids or eat.

Breast cellulitis is a condition that may arise after breast-conserving surgery or radiation therapy for people who have cancer. It is similar to a breast abscess but has a greater tendency to spread around under the skin instead of pooling into one pocket like an abscess. Common symptoms of this condition include the build-up of fluids (edema), warmth, tenderness, pain, swelling, rash, and redness (erythema).

Perianal streptoccocal cellulitis is an infection of the anus and rectum. Often, it develops during or after strep throat, nasopharyngitis, or a streptococcal skin infection. Common symptoms of this condition include fever, itching, pain, bleeding with bowel movements, and redness around the anus.

Treatments for Bacterial Skin Infections

1. Home Remedies

Several remedies may be done at home to relieve pain and ease some symptoms of bacterial skin infections. You can clean the affected area. Remember to ask your doctor how to do proper cleaning. For instance, when your leg is affected, you can raise it above the level of your heart. This helps reduce swelling and relieve pain.

2. Surgery

Generally, antibiotics clear up the infection. But, if you have an abscess, it may need to be drained with surgery. The surgeon would administer a local anesthetic, make a small cut in the abscess, then allow the pus to drain out. After this, the wound is covered with dressing so it can heal.

3. Antibiotics

To eradicate bacterial skin infections and to avoid complications, antibiotics are sometimes used as treatment. Common antibiotics that may be used are cefuroxime, ceftazidime, azithromycin, erythromycin, imipenem & cilastatin, levofloxacin, ciprofloxacin, vancomycin, penicillins, amoxicillin, amoxicillin and clavulanate, ampicillin and sulbactam, piperacillin and tazobactam, cefazolin, cephalexin and ceftriaxone3. In some cases, doctors use may corticosteroids for autoimmune disorders.

Generally, doctors treat bacterial skin infections according to the location of the infection, type of bacteria, the severity of the infection, and the overall health of the patients.

Bacterial skin infections are common infections, and they are treatable. Usually, patients are treated in the out-patient department because medications (usually antibiotics) can be taken at home. However, there should be proper evaluation of the condition and its symptoms because, in severe cases, it can cause death.

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