Cellulitis: Symptoms, Treatment, and Next Steps - Surgery

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Cellulitis


Hello Dr.
Li, I have developed lesions resembling folliculitis near the groin area at the top of my thigh, accompanied by symptoms of redness, swelling, heat, and pain.
I was later diagnosed with cellulitis at a nearby hospital, where I underwent debridement and had a packing with gauze to absorb the tissue fluid, and I was prescribed oral antibiotics to take at home.
After returning home, I noticed that the area of redness and swelling has expanded along the groin.
Could this be related to an incomplete drainage of an abscess? The medication does not seem to be effective.
Is there a possibility of developing peritonitis? What should my next steps be? Should I finish the medication and then return for a follow-up, or...? I would appreciate your guidance when you have the time.
Thank you.

Chongren, 40~49 year old female. Ask Date: 2018/06/08

Dr. Li Zhonghuai reply Surgery


Hello! It is recommended to be hospitalized for antibiotic treatment.
A ruptured sebaceous cyst combined with an abscess and cellulitis may require debridement 2 to 3 times before healing.
Wishing you well! Changhua Hospital cares about you!

Reply Date: 2018/06/08

More Info


Cellulitis is a common and potentially serious bacterial skin infection that can cause redness, swelling, warmth, and pain in the affected area. It often occurs when bacteria enter the skin through a cut or break, leading to inflammation of the skin and underlying tissues. In your case, the symptoms you described—redness, swelling, and pain in the groin area—are consistent with cellulitis, particularly after the diagnosis of folliculitis.

The treatment for cellulitis typically involves antibiotics, which are crucial for combating the infection. In your situation, it appears that you have already undergone a surgical procedure to drain any abscess or collection of pus, which is an important step in managing cellulitis. However, the fact that the redness and swelling have continued to expand may indicate that the infection is not fully resolved or that there is an underlying issue, such as an abscess that was not completely drained.

Regarding your concern about the possibility of developing peritonitis, it is important to note that peritonitis is an inflammation of the peritoneum, the lining of the abdominal cavity, often caused by infection. While cellulitis itself does not directly cause peritonitis, if the infection spreads or if there is a deep-seated abscess that communicates with the abdominal cavity, there could be a risk. Symptoms of peritonitis may include severe abdominal pain, fever, and a rigid abdomen. If you experience any of these symptoms, it is crucial to seek immediate medical attention.

As for your next steps, it is essential to follow your healthcare provider's instructions regarding the antibiotic regimen. Completing the full course of antibiotics is important, even if you do not see immediate improvement. However, if the area continues to worsen or if you develop new symptoms, you should not hesitate to return to your healthcare provider for further evaluation. They may need to reassess the area, possibly perform imaging studies, or consider a different antibiotic if the current one is ineffective against the bacteria causing your infection.

In summary, while it is important to complete your antibiotic treatment, you should also monitor your symptoms closely. If you notice any worsening of your condition or new concerning symptoms, such as fever or increased pain, you should seek medical attention promptly. Communication with your healthcare provider is key to ensuring that your cellulitis is adequately treated and to prevent any potential complications.

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