S68 Cellulitis (ICD-10:L03.9)

February 28, 2024

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Introduction

Cellulitis is a common bacterial skin infection that affects the deeper layers of the skin. It is characterized by redness, swelling, warmth, and pain in the affected area. Cellulitis can occur anywhere on the body, but it most commonly affects the legs. The aim of this guide is to provide healthcare professionals with a comprehensive overview of the diagnostic steps and possible interventions for cellulitis.

Codes

– ICPC-2 Code: S68 Cellulitis
– ICD-10 Code: L03.9 Cellulitis, unspecified

Symptoms

  • Redness and inflammation of the skin
  • Swelling and warmth in the affected area
  • Pain or tenderness
  • Skin that feels tight or stretched
  • Fever and chills
  • Blisters or skin abscesses in severe cases

Causes

  • Bacterial infection, most commonly caused by Streptococcus or Staphylococcus bacteria
  • Breaks or cracks in the skin, such as cuts, insect bites, or surgical wounds
  • Chronic conditions that weaken the immune system, such as diabetes or peripheral vascular disease

Diagnostic Steps

Medical History

  • Gather information about the patient’s risk factors, such as recent skin injuries or surgeries, chronic medical conditions, and previous episodes of cellulitis
  • Ask about symptoms, including the location and duration of redness, swelling, and pain
  • Inquire about any fever or chills

Physical Examination

  • Inspect the affected area for redness, swelling, warmth, and tenderness
  • Assess the size and shape of any blisters or abscesses
  • Check for enlarged lymph nodes near the affected area
  • Evaluate the patient’s vital signs, including temperature, heart rate, and blood pressure

Determine Severity

  • Mild cellulitis: Limited area of redness and swelling, no systemic symptoms
  • Moderate cellulitis: Larger area of redness and swelling, mild systemic symptoms (e.g., low-grade fever)
  • Severe cellulitis: Extensive redness and swelling, severe systemic symptoms (e.g., high fever, rapid heart rate)

Laboratory Tests

  • Complete blood count (CBC): Elevated white blood cell count may indicate infection
  • Blood cultures: Identify the specific bacteria causing the infection
  • Wound culture: Collect a sample from any open sores or abscesses to determine the bacteria involved
  • Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP): Measure inflammation levels in the body

Diagnostic Imaging

  • X-ray: Used to rule out underlying bone infection or foreign bodies
  • Ultrasound: Can help identify fluid collections or abscesses
  • MRI or CT scan: Reserved for severe cases or when deeper tissue involvement is suspected

Follow-up and Patient Education

  • Advise the patient to complete the full course of antibiotics as prescribed
  • Instruct the patient to elevate the affected limb, if applicable, to reduce swelling
  • Educate the patient about proper wound care and hygiene to prevent future infections
  • Schedule a follow-up appointment to monitor the progress of treatment and ensure resolution of symptoms

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Cellulitis:

  1. Antibiotics (e.g., Cephalexin, Dicloxacillin, Clindamycin):
    • Cost: Generic versions can range from $10 to $50 for a course of treatment.
    • Contraindications: Allergy to penicillin or cephalosporins.
    • Side effects: Nausea, diarrhea, rash.
    • Severe side effects: Severe allergic reactions, Clostridium difficile infection.
    • Drug interactions: Warfarin, oral contraceptives.
    • Warning: Complete the full course of antibiotics to prevent recurrence and antibiotic resistance.
  2. Pain relievers (e.g., Acetaminophen, Ibuprofen):
    • Cost: Generic versions can range from $3 to $10 for a course of treatment.
    • Contraindications: Allergy to nonsteroidal anti-inflammatory drugs (NSAIDs), history of gastrointestinal bleeding.
    • Side effects: Upset stomach, dizziness.
    • Severe side effects: Gastrointestinal bleeding, kidney damage.
    • Drug interactions: Blood thinners, other NSAIDs.
    • Warning: Take with food to minimize stomach upset.
  3. Antipyretics (e.g., Acetaminophen):
    • Cost: Generic versions can range from $3 to $10 for a course of treatment.
    • Contraindications: Allergy to acetaminophen, severe liver disease.
    • Side effects: None when used as directed.
    • Severe side effects: Liver damage (with excessive use).
    • Drug interactions: Alcohol, other medications containing acetaminophen.
    • Warning: Do not exceed the recommended dose.
  4. Anti-inflammatory creams (e.g., Hydrocortisone):
    • Cost: Generic versions can range from $5 to $15 for a tube.
    • Contraindications: Allergy to corticosteroids, skin infections.
    • Side effects: Skin thinning, burning or stinging sensation.
    • Severe side effects: None when used as directed.
    • Drug interactions: None known.
    • Warning: Use sparingly and for a limited duration to avoid skin thinning.
  5. Antihistamines (e.g., Diphenhydramine):
    • Cost: Generic versions can range from $3 to $10 for a course of treatment.
    • Contraindications: Allergy to antihistamines, narrow-angle glaucoma.
    • Side effects: Drowsiness, dry mouth.
    • Severe side effects: None when used as directed.
    • Drug interactions: Alcohol, other sedating medications.
    • Warning: Avoid driving or operating heavy machinery while taking this medication.

Alternative Drugs:

  • Topical antibiotics (e.g., Mupirocin): Used for localized infections or as adjunctive therapy.
  • Oral corticosteroids (e.g., Prednisone): Reserved for severe cases with significant inflammation.
  • Intravenous antibiotics (e.g., Vancomycin, Ceftriaxone): Administered in hospitalized patients or those with severe cellulitis.

Surgical Procedures:

  • Incision and drainage: Used for abscesses or fluid collections that do not respond to antibiotics. Cost: $500 to $2,000.
  • Debridement: Removal of dead or infected tissue to promote healing. Cost: $1,000 to $5,000.
  • Skin grafting: Reserved for severe cases with extensive tissue loss. Cost: $5,000 to $15,000.

Alternative Interventions

  • Warm compresses: Apply warm, moist compresses to the affected area to promote circulation and reduce swelling. Cost: Free.
  • Elevation: Elevate the affected limb to reduce swelling and improve lymphatic drainage. Cost: Free.
  • Herbal remedies: Some herbs, such as calendula or tea tree oil, may have antimicrobial properties. Cost: Varies depending on the specific herb or oil.
  • Homeopathic remedies: Homeopathic remedies, such as Apis mellifica or Belladonna, may be used to alleviate symptoms. Cost: Varies depending on the specific remedy.
  • Acupuncture: May help improve circulation and reduce pain. Cost: $60 to $120 per session.

Lifestyle Interventions

  • Proper wound care: Cleanse the affected area with mild soap and water, apply an antibiotic ointment, and cover with a sterile dressing. Cost: Varies depending on the specific wound care products.
  • Weight management: Maintain a healthy weight to reduce the risk of skin breakdown and infection. Cost: Varies depending on the chosen weight management program.
  • Diabetes management: Control blood sugar levels in patients with diabetes to prevent complications and promote wound healing. Cost: Varies depending on the specific diabetes management regimen.
  • Hygiene practices: Encourage regular handwashing and proper hygiene to prevent the spread of bacteria. Cost: Varies depending on the chosen hygiene products.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

  • Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
  • Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
  • Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
  • Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
  • Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

MildModerateSevere
Mode setting: 2 (Wound Healing)
Location: 0 (Localized)
Morning: 15 minutes,
Evening: 15 minutes
Mode setting: 2 (Wound Healing)
Location: 0 (Localized)
Morning: 30 minutes,
Lunch: 30 minutes,
Evening: 30 minutes
Mode setting: 2 (Wound Healing)
Location: 0 (Localized)
Morning: 30 minutes,
Lunch: 30 minutes,
Evening: 30 minutes
Mode setting: 10 (Dermatitis/Fungus)
Location: 0 (Localized)
Morning: 15 minutes,
Evening: 15 minutes
Mode setting: 10 (Dermatitis/Fungus)
Location: 0 (Localized)
Morning: 30 minutes,
Lunch: 30 minutes,
Evening: 30 minutes
Mode setting: 10 (Dermatitis/Fungus)
Location: 0 (Localized)
Morning: 30 minutes,
Lunch: 30 minutes,
Evening: 30 minutes
Mode setting: 7 (Immunotherapy)
Location: 6 (Throat, Lymphatic & Thyroid)
Morning: 15 minutes,
Evening: 15 minutes
Mode setting: 7 (Immunotherapy)
Location: 6 (Throat, Lymphatic & Thyroid)
Morning: 30 minutes,
Lunch: 30 minutes,
Evening: 30 minutes
Mode setting: 7 (Immunotherapy)
Location: 6 (Throat, Lymphatic & Thyroid)
Morning: 30 minutes,
Lunch: 30 minutes,
Evening: 30 minutes
Total
Morning: 45 minutes approx. $7.50 USD,
Evening: 45 minutes approx. $7.50 USD
Total
Morning: 90 minutes approx. $15 USD,
Lunch: 90 minutes approx. $15 USD,
Evening: 90 minutes approx. $15 USD,
Total
Morning: 90 minutes approx. $15 USD,
Lunch: 90 minutes approx. $15 USD,
Evening: 90 minutes approx. $15 USD,
Usual treatment for 7-60 days approx. $105 USD  $900 USDUsual treatment for 6-8 weeks approx. $1,890 USD – $2,520 USD
Usual treatment for 3-6 months approx. $4,050 USD – $8,100 USD
Location note miraridoctor 1
  • Localized (0)
  • Sacrum (1)
  • Prostate & Uterus (2)
  • Kidney, Liver & Spleen (3)
  • Heart, Bile & Pancreas (4)
  • Lungs (5)
  • Throat, Lymphatic & Thyroid (6)
  • Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Cellulitis effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

  • Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

  • Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
  • Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
  • Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

  • Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
  • Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

  • Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Cellulitis. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

  • Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
  • Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
  • Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
  • Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
  • Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
  • Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.
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