Erysipelas vs. Cellulitis

January 26, 2021

Erysipelas and cellulitis are often hard to tell apart because they are quite similar. In general, erysipelas involves the outer layers of the skin, while cellulitis is found in deeper layers, sometimes spreading deep to the skin. Erysipelas is usually caused by Streptococcus bacteria but can also be caused by Staphylococcus. Cellulitis is usually caused by Staphylococcus.

Both conditions often affect the feet and lower legs. Erysipelas causes very well-defined shiny, reddened areas of skin that are usually painful, along with fever and general feeling of unwellness. Blisters can form in severe cases. Cellulitis causes darker red, less well-defined, painful, swollen skin. Fever and general feeling of unwellness are less common. It may be counterintuitive, but the more superficial infection of the two (erysipela) tends to be more serious.

Both diseases are caused when breaks in the skin, such as insect bites, scratches, or fungal infections, let in bacteria. Infections can become serious if not treated. Sepsis, or infection of the blood, or osteomyelitis, an infection of the underlying bone, can complicate matters if prompt action is not taken. Early cases may be treated in outpatient settings:

  • Keflex (cephalexin) can be taken for 7 to 10 days by mouth in a dosage of 1 gram twice daily.
  • Augmentin (amoxicillin/clavulanic acid) can be taken in a dose of 2 tablets twice a day for 7 to 10 days.
  • Clindamycin
  • Bactrim

Remember that even if an effective antibiotic is started, the affected area can still increase by as much as 50% in size. If no improvement is seen within 3 days, or the patient becomes significantly worse, with high fevers, patients may be admitted to hospitals for IV antibiotic treatment.


Did you know? QuickMD can treat erysipelas or cellulitis in the comfort and convenience of your own home, and prescribe antibiotics for cellulitis online.

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