(2001; 179 pages)
Cellulitis and erysipelas
Cellulitis and erysipelas are streptococcal infections of the subcutaneous tissues, which usually result from contamination of minor wounds. Both conditions are characterized by acute localized inflammation and oedema. The lesions are more superficial in erysipelas than in cellulitis and have a well defined, raised margin. Potentially fatal systemic toxaemia may supervene in patients who remain untreated. Recurrent cellulitis or erysipelas can result in chronic lymphoedema which may, in turn, serve as a predisposing factor for recurrent episodes of infection.
In infants, facial lesions similar to those of cellulitis and erysipelas may be caused by Haemophilus influenzae; however, this condition is rare in countries where H. influenzae vaccination programmes have been instituted.
Procaine benzylpenicillin 1.5 million IU (children: 50 000IU/kg; maximum 1.5 million IU) i.m. every 24 hours for 7 - 10 days
benzylpenicillin 1 - 2 million IU (children: 50 000 - 100 000IU/kg; maximum 2 million IU) i.v. or i.m. every 6 hours for 7 - 10 days (once clinical improvement occurs, amoxicillin 500 mg (children: 7.5 - 15mg/kg; maximum 500mg) orally every 8 hours may be substituted)
cefazolin 1 - 2 g (children: 15mg/kg; maximum 2g) i.v. or i.m. every 8 hours for 7 - 10 days (once clinical improvement occurs, cefalexin 500 mg (children: 12.5 - 25mg/kg; maximum 500mg) orally every 6 hours may be substituted).