No, we are not talking about a condition related to obesity. Our obsession with weight has brought about confusion in regard to how many of words are used. Contrary to what most people think, you do not have to be overweight to have cellulitis. And, cellulitis is not to be confused with the cosmetic concern known as cellulite. Cellulitis is a serious condition. It is generally an acute, spreading infectious process that initially affects the layers of the skin and then may spread within the layer of connective tissue that lies just below the surface of the skin called the superficial fascia.(1) Infections of the skin and soft tissue are among those most commonly seen both in and out of the hospital setting.

Cellulitis is considered a serious condition because of the tendency for it spread through the lymphatic system and then into the bloodstream. Bacteremia may be present in as many as 30 percent of cases. Other complications include the possibility of thrombophlebitis, particularly in the elderly population.

The skin and tissues just under the skin are normally extremely resistant to infection. Even when high concentrations of bacteria are applied topically or injected into the soft tissue, it is rare for an infection to take hold.(2)

Our skin is a tough barrier to infection and there are several reasons for this. The surface of the skin is usually a pretty dry place so it is not really the environment that makes a good home for bacteria. Also, the skin continues to renew itself by shedding cells and along with them, bacteria. Any situation that changes the normal condition on the skin, our largest organ, puts it in danger of becoming infected. Some of these conditions include abrasions, disease, punctures, and various infections. The areas of the body that are most sensitive to infection are the areas which are generally exposed such as the face, neck, and hands. These areas usually have the highest bacterial density. Cellulitis is usually caused by two microorganisms known as Streptococcus pyogenes or Staphylococcus aureus. There are other types of organisms which can cause cellulitis that could be seen in patients with diabetic foot problems. This infection is much more complicated. Finally, one of the more exotic possible ways to get cellulitis would be through an insect bite such as the bite of a brown recluse spider. Finally, dry, cracked skin that remains uncared for may become secondarily infected.(3)

One particular type of cellulitis occurs in children between the ages of one and five years. This is known as Haemophilus influenza. This type of cellulitis is often associated with an upper respiratory infection and involves the face, neck, or upper extremities. In children, the lesions are usually blue-red or purple-red and are swollen.