This document discusses cellulitis, a bacterial skin infection. It begins by defining cellulitis and describing the bacteria that cause it. Risk factors include injuries, skin conditions, and diabetes. Common sites are the lower limbs. Symptoms include swelling, redness, warmth, and pain. Complications can include abscesses, sepsis, and necrotizing fasciitis. Homeopathic medicines like Belladonna, Apis, and Ledum are used to treat symptoms and support healing. The document provides an overview of cellulitis, including causes, presentation, treatment, and homeopathic perspectives.

1. STATE LAL BAHADUR
SHASTRI HOMOEOPATHIC
MEDICAL COLLEGE AND
HOSPITAL , PRAYAGRAJ
UNDER THE GUIDANCE OF –
DR MUKESH KUMAR SHRIVASTAVA SIR ( HOD
DEPARTMENT OF SURGERY )
SUBMITTED BY
AASTHA TIWARI ( ROLL NO – 1)
BHMS III YEAR

2. ACKNOWLEDGEMENT
 I am immenselygrateful to my professor Dr Mukesh Kumar Shrivastava
Sir ( HOD Department of Surgery ) for giving me this wonderful
opportunity to work on this very crucial topic “ Cellulitis “ through
which I came across certain very important informations regarding
this disease as it requires a lot of research work .
 Thank you sir for guiding me through out the completion of this
project .

3. Certificate
This is to certify that Aastha Tiwari of batch 2019 has completed the project
on topic Cellulitis under the guidance of Dr Mukesh Kumar Shrivastava Sir (
hod of department of Surgery lbsh medical college prayagraj )
Signature

4. INDEX
 Introduction
 Organisms responsible
 Predisposing risk factors
 Precipitating factors
 Common sites involved
 Sub types of Cellulitis
 Clinical presentation
 Treatment and Management
 Complications
 Diagnosis
 Homoeopathic therapeutics

5. Introduction
 Cellulitis is an acute , diffuse , spreading infection of
the skin .
 It involves deeper layers of skin as well as
subcutaneous tissues .
 It is a bacterial infection, resulting in the inflammatory
exudation , which eventually spread to subcutaneous
region as well as Fascial planes ( i.e space between
two fascial layers )
 This results in swelling and redness with itching .

6. Organisms responsible
 It is a bacterial infectioncaused by –
 haemolytic Streptococcus Group A and B
 Staphylococcus
 Haemophilus influenzae ( periorbital cellulitis )
 Pasturellamultocida( facial cellulitis in children less than
3 years )
 Streptococcus pneumoniae

8. Predisposing risk factors
 Injuries ( minor or major ) .
 Local trauma ( laceration , insect bites ,
wounds due to other causes , shaving cuts ) .
 Previous skin infection( scabies , impetigo ,
tinea pedis ).
 Underlying skin ulcers .
 Extremely sensitive skin .

9. Precipitating factors
 Immunocompromised patient
 Diabetes mellitus
 Oedema secondary to venous insufficiency

10. Sites affected commonly
 Lower limbs
 Face
 Scrotum
 Submental
 Submandibular ( Ludwig’s Angina)
 Periorbital region
 Upper limbs

11. Subtypes – LUDWIG’S ANGINA
1. Cellulitis of submental and submandibular regions
2. Inflammatory oedema of the floor of mouth , tongue is
pushed upward difficulty in swallowing
3. Fever may also present
4. Putrid halitosis is characteristic of this condition.
5. Complications –
6. Mediastinitis and septicemia
7. Oedema of glottis

12. 2 LYMPHANGITIS
 It is localisedinfection caused by
Streptococcus , staphylococcus and
clostridium
 Painful red streaks are present
 Filarial infection is one of the cause
 High fever , chills , painful lymph nodes

13. Clinical presentation
Local symptoms
1. Diffuseswelling
2. Redness along with itching
3. Warm to touch
4. Tense and firm in palpitation
5. May resemble to “peau 'd’ orange
6. Edges are diffuse not demarcated
7. Small amount of purulent discharge

14. SYSTEMIC INDICATION
 Increased temperature
 Increased pulse rate
 Lymphadenopathy of regional lymph nodes / lymphangitis

15.  Unilateral
 Pus is absent
 No fluctuations

16. COMPLICATIONS
 Cellulitis may progress into abscess .
 Then it needs to be drained to prevent further complications .
 Certain dangerous strains of “ Streptococcus pyogenes “ can cause
necrosis of skin , subcutaneous tissues . This is called“ Necrotising fasciitis “.
 Treatment - Debridement and skin grafting .
 Septicemia It can cause toxic shock syndrome as endoto are released by
bacteria .
 Ketoacidosis in patient of diabetes mellitus.

17. Threatening complications
 Blood infection – septicemia
 Bone infection – osteomyelitis
 Inflammationof heart
 Meningitis
 Shock
 Death

18. Diagnosis
 History of any injury , ulcer , diabetes , insect bites etc
 Physical examination
 Complete blood count
 Culture and sensitivity test

19. MANAGEMENT
 Bed rest with raised or elevated legs – reduce oedema
of legs .
 MgSo4 dressing to reduce oedema by osmotic effect .
 If history of diabetes mellitus is present then try to
control it by medicationor subcutaneous injection of
insulin.
 Antibiotics to control spread .
 Antisnake venom for Cellulitis caused by snake bite .

20. Homoeopathic therapeutics
 Belladonna
 Apis mellifica
 Ledum pal
 Silicea
 Pyrogenium
 Calendulaofficinalis
 Rhus toxicodendron
 Lachesis
 Arnica

21. Belladonna
 Belladonnaacts as a very good medicine for
cellulitis
 The skin is markedly red and swollen
 Along with this there is shining appearance
 Patient requiring belladonnawill experience intense
pain which gets worse by touch
 The pain appear and disappear suddenly
 Marked feature dryness of skin with much heat

22. Apis mellifica
 Suited in those cases of Cellulitis in which there is much
swelling in affected area along with burning
 Stinging type of pain
 Burning pain are relieved by applying something cold over
skin
 Pain rapidly shift from one part to another
 Rosy hue of skin with sensitivity to touch
 Cellulitis due to honey bee sting

23. Ledum Palsture
 Cellulitis due to insect bites
 Coldness of affected part with tearing type of
pains
 It can be used in long standing cases of
Cellulitis in which skin colour changes from blue
to green

24. Silicea
 It gives good results when blebs are formed on skin
in advanced cellulitis cases .
 Blebs can contain offensivepus .
 It is also used when along with cellulitis there is fever
with chilliness and offensive perspiration

25. Pyrogenium
 It is an excellent remedy for treatment of septicemia
resulting from cellulitis
 Septic conditions, fever with chills
 Body temperature 103- 106 degree with abnormally
rapid pulse rate
 Restless patient
 Excessive chilliness in back
 Septicemiaoccuring after surgery or childbirth

26. Calendula officinalis
 Cellulitis after surgical cuts
 If applied locally to wounded skin after injury act
as preventive medicine as well
 Used in treatment as well as prevention

27. Rhus toxicodendron
 Cellulitis with skin red and swollen
 Aggravation from cold , wet , rainy weather
 Better by warm application
 Patient is very much restless

28. Lachesis
 Used in severe cases of Cellulitis
 Blue black swelling
 Pus filled dissecting wounds
 Cellulitis in old age
 Better by discharge of pus and warm application
.

29. Bibliography
 References of the topic are been taken from
1. Books
 Manipal manual of surgery
 SRBs manual of surgery
 Borericke materiamedica
 Allen’s keynote for homoeopathictherapeutics
2. Internet
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