Cellulitis: Scrotal, Lymphedema, Perineal: Symptoms, Causes, Treatment

The term ‘cellulitis’ refers to a variety of skin infections that can occur anywhere on the body and are caused by various bacteria. Normally, the main bacterial players are Streptococcus and Staphylococcus species. However, when the genitals are involved, the beta-hemolytic streptococci is normally the culprit. Often, there is no point of entry for the bacteria, especially if it involves lymphedema cellulitis. In such situations, the causes appear to be a malfunctioning lymph system. However, in patients who do not suffer from lymphedema, the diagnosis is even more challenging and puzzling.

Scrotal Cellulitis Symptoms

The scrotum swells to abnormal proportions. Scrotal cellulitis results from a bacterial invasion. On rare occasions, a perirectal abscess is how the bacteria gained access to the region. With the disorder, fluid builds up in the delicate area between Buck’s fascia and the Colles’. The fluid causes the scrotum to swell to a massive size. Scrotal cellulitis usually requires immediate incisions or the skin of the penis and scrotum will tear from the excessive pressure.

If tearing occurs, then gangrene can rapidly develop. In addition, treatment with an antibiotic such as penicillin is necessary to control the bacteria’s rapid growth. If the antibiotics do not halt the spread of the infection and the skin dies from gangrene, then radical removal of the decaying necrotic tissue is mandatory to save the patient’s life and control the infection. If removing the decayed tissue is not achieved then the gangrene continues to progress. Normally, it takes extensive treatment rounds of antibiotics to control the bacteria.

Perineal Cellulitis

Perianal streptococcal dermatitis is a red, itchy rash that occurs on the perineum. The disorder arises because of A beta-hemolytic streptococci. The sufferer experiences intense itching accompanied by the additional symptoms of rectal pain. The stool is often coated in fresh, red blood. This condition occurs mostly in infants six months and older or children up to the age of 10. If the condition progresses, it can cause perineal cellulitis. Most medical guides list amoxicillin or penicillin as effective treatments. The rate of reoccurrence is exceptionally high. Please take a moment to look over the pictures of the condition.

What is Lymphedema?

People who suffer from lymphedema have to deal with an accumulation of fluid in their tissue. The legs and arms are at special risk. The fluid pools in the body’s lymphatic system. In a healthy person, the lymph fluid flows and circulates, but if an obstruction occurs, then the fluid backs up into the surrounding tissue and causes edema. Researchers speculate that the condition occurs because of a genetic mutation. Also, infections or inflammatory conditions can compound the problem. Cancer sufferers, especially those who have been treated for lymphatic cancers, often suffer from secondary lymphedema. Radiation treatments also damage the lymph nodes which leads to the lymphedema. The chronic swelling can cause skin infections such as cellulitis. All sufferers should go through Complex decongestive therapy (CDT) to control the edema.

CDT includes:

  • Exercises to get the fluid flowing and circulating.
  • Focused external care
  • Manual lymphatic drainage (MLD). MLD involves massage to push and move the fluid through the body’s lymph nodes.
  • Multilayer lymphedema bandaging (MLLB): A tight bandage or compression tights are placed on the body to encourage the fluid to move.

Surgical Procedures for Lymphedema

Surgery for lymphedema is no longer performed often because it has always been a dismal failure. However, modern liposuction has shown promise.

Lymphedema Cellulitis Susceptibility

Sufferers of lymphedema are at special risk for developing cellulitis. The lymphatic system is incapable of clearing out fluid or fighting infections. If a scratch or break in the skin occurs when bacteria invades and takes up residence. Even a bug bite becomes a pathway for bacteria. Other causes of infection that lead to cellulitis include eczema, dermatitis, and athlete’s foot. The overload of bacteria and water causes the cellulitis to rapidly take control.

Symptoms of Cellulitis

If you suffer from cellulitis of the scrotum, perineum or pubic region, then you will suffer from the following:

  • Fever
  • Muscle aches
  • Headache
  • Nausea
  • Vomiting
  • Pain
  • Chills or shivers

The area infected area will be flaming red and hot to the touch. Additional swelling in the groin might manifest as the lymph nodes become overloaded.

Even if the point of entry for the bacteria was a toe or finger, the infection can spread to further regions such as the genitals.

Understanding Cellulitis

Cellulitis attacks the deep layers of the skin. In the genital region, such as the scrotum, penis, and perineum, the pain can be extreme. The area might display blisters, open sores, and skin dimpling. Prompt care is imperative before the infection progresses and septic shock takes hold. The bacteria use the lymph nodes and bloodstream to become widespread and deadly.

The lymph vessels may suffer permanent damage and the blood-borne infection becomes systemic. If cellulitis is caught early, focused wound care and antibiotics typically improve the condition in 24 to 48 hours. If the condition is severe, then you will require hospitalization and surgical drainage. Let go the condition can quickly become fatal as the skin atrophies and putrescence spreads, especially throughout the genital region.



Article References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/1098183
  2. https://jamanetwork.com/journals/jamadermatology/article-abstract/395318
  3. https://www.ncbi.nlm.nih.gov/pubmed/16868660
  4. https://www.lymphoedema.org/index.php/cellulitis/about-cellulitis
  5. https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762