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Cellulitt

Sist revidert:
Sist revidert av:
Definisjon:
Cellulitt er en ikke-purulent akutt infeksjon i hud og underhud
Forekomst:
Vanlig i allmennpraksis og ved sykehus
Symptomer:
Lokalisert erytem og varme, hevelse, moderate smerter, tidvis hudblødninger, bullae og ofte allmennsymptomer
Funn:
Uskarpt avgrenset erytem, inhomogen farge, satelitter, lesjoner
Diagnostikk:
Anamese og klinisk undersøkelse
Behandling:
Antibiotika, elevasjon, kompresjon - ev. eksplorasjon ved mistanke om dypere eller alvorligere infeksjoner. Behandle disponerende faktorer om aktuelt
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  2. Bruun T, Oppegaard O, Kittang BR, et al. Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study. Open Forum Infect Dis. 2015 Nov 25;3(1):ofv181. PMID: 26734653. PubMed  
  3. Cranendonk DR, Lavrijsen APM, Prins JM, Wiersinga WJ. Cellulitis: current insights into pathophysiology and clinical management. Neth J Med. 2017 Nov;75(9):366-378. PMID: 29219814. PubMed  
  4. Chambers HF. Cellulitis, by any other name. Clin Infect Dis. 2013 Jun;56(12):1763-4. Epub 2013 Mar 1. PMID: 23457076. PubMed  
  5. Oppegaard O, Mylvaganam H, Kittang BR. Beta-haemolytic group A, C and G streptococcal infections in Western Norway: a 15-year retrospective survey. Clin Microbiol Infect. 2015 Feb;21(2):171-8. Epub 2014 Oct 14. PMID: 25658557. PubMed  
  6. Cannon J, Rajakaruna G, Dyer J, Carapetis J, Manning L. Severe lower limb cellulitis: defining the epidemiology and risk factors for primary episodes in a population-based case-control study. Clin Microbiol Infect. 2018 Oct;24(10):1089-1094. Epub 2018 Feb 7. PMID: 29427797. PubMed  
  7. DiNubile MJ, Lipsky BA. Complicated infections of skin and skin structures: when the infection is more than skin deep. J Antimicrob Chemother 2004; 53: 37. pmid:15150182 PubMed  
  8. McNamara DR, Tleyjeh IM, Berbari EF. Incidence of lower-extremity cellulitis: a population-based study in Olmsted county, Minnesota. Mayo Clin Proc 2007; 82: 817. pmid:17605961 PubMed  
  9. Jeng A, Beheshti M, Li J, Nathan R. The role of beta-hemolytic streptococci in causing diffuse, nonculturable cellulitis: a prospective investigation. Medicine 2010; 89: 217-26. PubMed  
  10. Gunderson CG, Martinello RA. A systematic review of bacteremias in cellulitis and erysipelas. J Infect. 2012 Feb;64(2):148-55. Epub 2011 Nov 11. PMID: 22101078. PubMed  
  11. Karakonstantis S. Is coverage of S. aureus necessary in cellulitis/erysipelas? A literature review. Infection. 2020 Apr;48(2):183-191. Epub 2019 Dec 16. PMID: 31845187. PubMed  
  12. Vinh DC, Embil JM. Rapidly progressive soft tissue infections. Lancet Infect Dis 2005; 5: 501. pmid:16048719 PubMed  
  13. Eron LJ, Lipsky BA. Use of cultures in cellulitis: when, how, and why?. Eur J Clin Microbiol Infect Dis 2006; 10: 615. pmid:16896821 PubMed  
  14. Rath E, Skrede S, Oppegaard O, Bruun T. Non-purulent skin and soft tissue infections: predictive power of a severity score and the appropriateness of treatment in a prospective cohort. Infect Dis (Lond). 2020 May;52(5):361-371. Epub 2020 Feb 13. PMID: 32052670. PubMed  
  15. Gottlieb M, Avila J, Chottiner M, et al. Point-of-Care Ultrasonography for the Diagnosis of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-analysis. Ann Emerg Med. 2020 Feb 17. pii: S0196-0644(20)30004-4. doi: 10.1016/j.annemergmed.2020.01.004. Pmid: 30119943.
  16. Ko LN, Garza-Mayers AC, St John J, et al. Clinical Usefulness of Imaging and Blood Cultures in Cellulitis Evaluation. JAMA Int Med 2018. doi:10.1001/jamainternmed.2018.0625 DOI  
  17. Swartz MN. Cellulitis. N Engl J Med 2004; 350: 904-12. PubMed  
  18. Akselsen PE. Erysipelas og cellulitt. Lindbæk M (red). Nasjonale faglige retningslinjer for antibiotikabruk i primærhelsetjenesten. Oslo: Helsedirektoratet. Sist oppdatert 16.06.2020. Siden lest 15.01.2021. www.antibiotikaiallmennpraksis.no  
  19. Rath E, Skrede S, Mylvaganam H, Bruun T. Aetiology and clinical features of facial cellulitis: a prospective study. Infect Dis (Lond). 2018 Jan;50(1):27-34. Epub 2017 Aug 2. PMID: 28768452. PubMed  
  20. Helsedirektoratet (2021). Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 16. november 2021, lest jan 2022).
  21. Williams OM, Brindle R. Antibiotic route and duration of therapy for cellulitis: data extracted from a multi-center clinical trial. Int J Antimicrob Agents. 2020 Sep;56(3):106076. Epub 2020 Jul 3. PMID: 32629112. PubMed  
  22. Brindle R, Williams OM, Davies P, et al. Adjunctive clindamycin for cellulitis: a clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis. BMJ Open. 2017 Mar 17;7(3):e013260. PMID: 28314743. PubMed  
  23. Nasjonal faglig retningslinje for Antibiotika i sykehus. Cellulitt. Sist faglig oppdatert 08.01.2018. Siden lest 31.01.2022 www.helsedirektoratet.no  
  24. Webb E, Neeman T, Bowden FJ, Gaida J, Mumford V, Bissett B. Compression Therapy to Prevent Recurrent Cellulitis of the Leg. N Engl J Med. 2020 Aug 13;383(7):630-639. PMID: 32786188 PubMed  
  25. Peghin M, Graziano E, Rovelli C, Grossi PA. Prevention and treatment of recurrent cellulitis. Curr Opin Infect Dis. 2023 Apr 1;36(2):95-101. Epub 2023 Feb 9. PMID: 36853755 PubMed  
  26. Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. New Engl J Med 1996; 334: 240. doi:10.1056
  27. Brindle, R.J., O’Neill, L.A. & Williams, O.M. Risk, Prevention, Diagnosis, and Management of Cellulitis and Erysipelas. Curr Derm Rep 9, 73–82 (2020). doi: 10.1007/s13671-020-00287-1.
  28. Oppegaard O, Skrede S, Mylvaganam H, Kittang BR. Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci. Front Microbiol. 2020 May 15;11:797. PMID: 32477287. PubMed  
  29. Cranendonk DR, Opmeer BC, van Agtmael MA et al. Antibiotic treatment for 6 days versus 12 days in patients with severe cellulitis: a multicentre randomized, double-blind, placebo-controlled, non-inferiority trial. Clin Microbiol Infect. 2020 May;26(5):606-612. Epub 2019 Oct 13. PMID: 31618678. PubMed  
  • Eivind Rath, indremedisiner og infeksjonslege, Haukeland Universitetssjukehus, Bergen

Tidligere fagmedarbeidere

  • Bjørn Waagsbø, overlege avdeling for infeksjonssykdommer, St Olavs Hospital, Trondheim