True/False statements regarding cellulitis are: 1. Caused by streptococcus pyogenes 2. Causes SIRS 3. Localised infection 4. Abscess if any should be drained 5. I & D should not be done

It is a non suppurative inflammation spreading along the subcutaneous tissue planes and across intercellular spaces. The term is a misnomer, as the lesion is one of the connective and interstitial tissue and not of the cells. The causative organism is mostly the streptococcus pyogenes, through a variety of aerobic and anaerobic bacteria may produce cellulitis. Pathology: The organism usually gains access through a wound and redness at the area of inflammation, but without definitive localization blebs and bullae form on the skin. central necrosis may occur at later stages. Clinical Feature: There is varying degree of fever and toxemia. The affected pa is very much swollen and painful. diabetic individual often suffers from cellulitis. On examination, the affected pa is warm, swollen and tender. There is pitting oedema and brawny induration. The surrounding lymph vessels may be seen as red streaks due to lymphangitis. The regional lymph nodes will be enlarged and tender with acute lymphadenitis. Treatment consists of (i) Rest and elevation of the pa to reduce oedema. (ii) Appropriate antibiotics preferably broad spectrum should be administered. (iii) Failure of inflammatory swelling to subside after 48 to 72 hrs suggests that an abscess has developed. In that case incision and drainage of the pus should be accomplished. Ref: L & B 25/e, Page 37; Sabiston 18/e, Page 307; Textbook Of Surgery 5/e, Page 68