Difference Between Cellulitis and Erysipelas

Cellulitis is a deep-tissue infection caused by Staphylococcus or Streptococcus pathogenic bacteria. The infection is usually on the extremities and shows up as red, swollen areas that are painful. This is a deep infection of the skin that can worsen into dangerous necrotizing fasciitis. In comparison to cellulitis, erysipelas is a superficial skin and lymph vessel infection commonly occurring due to group A beta-hemolytic Streptococcus. The infection affects the extremities but also commonly the face. With erysipelas, the skin has raised red and shiny patches of skin, and the person has a high fever. 

In short, cellulitis is a bacterial infection of the deeper skin tissues while erysipelas is a bacterial infection of the superficial layers of the skin and lymphatic vessels. Both conditions need antibiotic treatment to avoid serious complications.

What is Cellulitis?

Definition:

Cellulitis is inflammation of the skin and deep subdermal tissue as a result of bacterial infection. Usually, the bacteria involved are either Streptococcus pyogenes or Staphylococcus aureus. The Streptococcus causes more widespread of an infection, while Staphylococcus causes a localized response.If you have cellulitis, your skin will look red, it will be painful and swollen. You may also spike a fever and have some swollen lymph nodes as your body tries to fight the infection. The infection most commonly occurs on the legs and other extremities.

Complications and treatment:

Cellulitis can be dangerous because it can result in bacteria spreading to the bloodstream causing bacteremia. It can also result in necrotizing fasciitis where the tissue dies, necessitating amputation in some cases. This is why prompt treatment of cellulitis with antibiotics, such as penicillin, amoxicillin, and clindamycin, is crucial. Patients may also need to be tested for MRSA and treated accordingly with various antibiotics to control the infection. This is especially the case if the infection appears to be spreading rapidly and if the skin is starting to slough off, which may indicate that MRSA is present.

What is Erysipelas?

Definition:

Erysipelas is a bacterial infection of the lymphatic vessels and superficial dermis. The group A beta-hemolytic Streptococcus bacterium commonly causes this condition. Sometimes, other bacteria such as Staphylococcus can be implicated. Raised, reddened areas of the skin develop where the infection occurs. It is often found on the face and legs. Chills, a high temperature, and fatigue often occur in people who have this condition.

Complications and treatment

Some of the complications of erysipelas include the chance of abscess formation, blood clot formation in the veins, and gangrene. The condition is treated with antibiotics, such as cephalexin or penicillin. Streptococcus is usually the causative organism and MRSA is rare in cases of erysipelas. 

Difference between Cellulitis and Erysipelas?

Definition

Cellulitis is an infection that occurs in the deep skin layers (the dermis) and subcutaneous tissue. Erysipelas is an infection of the more superficial layers of the dermis and skin, and lymph vessels.

Diagnosis

Cellulitis is diagnosed by physical examination, and by blood and tissue cultures. A physical exam is usually how erysipelas is diagnosed.

Cause

The cause of cellulitis is Staphylococcus aureus or Streptococcus pyogenes bacteria. The cause of erysipelas is usually group A Streptococcus bacteria.

Symptoms

In the case of cellulitis, the affected area feels warm, sore, and is red and swollen; fever may be present. In the case of erysipelas there are red, shiny, raised skin patches that are sore, and a high fever may occur.

Treatment

Antibiotics, like clindamycin or penicillin can treat cellulitis. Penicillin or cephalexincan treat erysipelas.

Complications

Complications that can be due to cellulitis include bacteremia and necrotizing infection of the soft tissues. Complications of erysipelas include abscesses, clots in the veins, and gangrene.

Table comparing Cellulitis and Erysipelas

Summary of Cellulitis Vs. Erysipelas

• Cellulitis is an infection deep in the dermis and underlying tissues.
• Erysipelas is a superficial infection of the skin and lymph vessels.
• Both erysipelas and cellulitis can be treated using antibiotics.

FAQ

How to tell the difference between cellulitis and erysipelas?

Cellulitis is a deep infection of the skin and underlying tissues, appearing as broad deep red areas of skin. Erysipelas is a superficial skin infection appearing as red, shiny, and raised plaques of skin.

What key clinical finding differentiates erysipelas from cellulitis?

Erysipelas occurs as distinct and well-defined raised red areas of skin, while cellulitis is not a clearly defined area but rather a broad, red area of skin.

How do you identify erysipelas?

The red area occurs as raised patches of skin that appear shiny.

What is the best treatment for erysipelas?

The use of antibiotic therapy, specifically cephalexin or penicillin, can treat erysipelas.

 Which is more serious cellulitis or erysipelas?

In general, cellulitis is more serious having a higher mortality rate of 1%, while erysipelas is less than 1% mortality. However, erysipelas of the face can be dangerous.

What are 3 symptoms of cellulitis?

The skin feels warm to the touch, it is also red, and swollen.

What triggers erysipelas?

A break in the skin or an insect bite can act as a trigger for infection.

Who is most likely to get erysipelas?

People with diabetes, alcoholism, obesity, or who are pregnant are at higher risk of erysipelas.

What is the most common cause of erysipelas?

The pathogen most responsible for erysipelas is group A beta-hemolytic streptococci. 

What is the season of erysipelas?

The condition is more common in summer, perhaps because insect bites are more common at that time.

Can stress cause erysipelas?

Stress can make it harder for skin wounds to heal and may indirectly contribute to skin infections in this way.

How long is erysipelas contagious?

Erysipelas is not a contagious condition.

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