Cellulitis has prominent and favourite destinations on the human body but locations on the head and neck are not usually top of most people’s awareness agenda. Understanding the mechanics of how cellulitis works make this often underestimated condition easier to comprehend and manage.
Cellulitis on the head
This is occasionally caused by a bacterial infection lurking in either a tooth, the inner ear or within the eyelid. The symptoms of red, congested skin which is warm and inflamed can also be accredited to ingression of bacteria via a break in the skin.
Cellulitis on the head needs careful and considered diagnosis as the prospective causes are manifold.
Tonsular Cellulitis as an adjunct to Tonsillitis
Tonsillitis, unlike Cellulitis, is predominantly triggered by a virus rather than an assault of bacterial origin. For many years, surgery was the favoured curative option but preferred guides in the modern era opt to treat the infections and underlying cause rather than operate. Symptoms include swollen painful tonsils which are red and angry or coated with white/ yellow patches.
The patient, frequently a teenager or younger child, will experience pain and restriction when swallowing and voice may be adversely affected. On occasion, the bacteria can proliferate and extend into the surrounding tissues and membranes fostering tonsular cellulitis as a secondary complication. This can lead to pus-filled abscesses next to the tonsils – peritonsillar – or adjacent in the throat – parapharyngeal. The latter is more dangerous. There will also be extensive swelling around the tonsils and soft palate. Urgent antibiotic coverage often intravenously is required and abscesses where accessible are drained. This is a nasty contingent infection, the patient will feel unwell with fever and headaches and is unlikely to be able to eat.
Suffering from earache? Could it be cellulitis of the ear?
Infections in the outer ear canal, the passageway that connects the eardrum to the actual ear on your head, can develop a resultant cellulitis infection, something like swimmer’s ear – the entrapment of water in the ear after swimming or bathing – which provides the perfect moist, warm dark climate for bacteria to thrive. Reduced immune response for example, in someone who also suffers from diabetes, can provide the perfect storm of conditions to allow cellulitis of the ear to flourish. Use of foreign objects such as cotton buds is strongly discouraged for this reason as they can push external debris and any fluid or bacteria further down the ear canal precipitating an infection.
Cellulitis of the actual earlobe
If you love piercings then this is a very likely contributory factor to your swollen earlobe. A new incision for an earring or other jewellery must be treated as a surgical wound and cleaned and managed to prevent infection from thriving. But infection is not just confined to fresh piercings, it can impact people who have worn earrings for years. Occasionally, some skin types will react to certain products or metals. Stretching the ear with plugs or gauges, a relatively new fashion can invoke a similar response. Removing the item twice daily to clean the area is vital but sometimes, infection can predominate. Injury perhaps caused by a bite or entanglement of a long or heavy piece of jewellery can cause a similar result. Cellulitis of the earlobe is pretty easy to recognise and needs prompt attention from a doctor before it spreads.
Cellulitis on the neck
A popular destination for the tattooist’s needles, new body art must be cared for in line with the studio’s advice and recommendations to prevent superficial skin infections developing into cellulitis of the neck. Always use accredited and legal parlours where you can guarantee clean needles.
However, for the diagnostic clinician faced with cellulitis of the neck in the absence of colourful illustrations, this can be the presentation of a primary underlying disorder in the aerodigestive tract – for non-medics, this is the entire area of the mouth, nose, throat, vocal cords and the top part of the windpipe and oesophagus. These pictures indicate the diagnostic challenge that these cases can present. The cellulitis will be treated instantaneously usually with a Penicillin based medication whilst the real generating root cause is identified.
Yes, it is really a thing but fortunately, a rare occurrence. The proper moniker is Dissecting Cellulitis of the scalp and it manifests as lumps, bumps and spots which fill with pus and subsequently cause hair loss which is distressing. Hair loss is largely permanent as the bacteria destroy the hair follicle and the consequent scar tissue prevents re-growth. The posh name for cellulitis of the scalp is Perifolliculitis capitis abscedens et suffodiens and it is more prevalent in men than women, with a tendency towards Afro-Caribbean ethnicity but not exclusively. Causes remain a bit of a mystery but are thought to involve just a sole infected hair follicle which then escalates.
Nasal Vestibulitis and Cellulitis in the nose
The nasal vestibule labels the area you can access with your finger, it can be prone to infection as a digit or piercings can trap normal skin bacteria. Cellulitis in the nose usually presents as swelling at the tip of the nose which then spreads to the cheeks. Treatment is as for all cases of cellulitis, oral antibiotic medication.
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