Lymphedema and Infections

What is bacterial cellulitis?

Bacterial cellulitis is an acute inflammation of your skin and the deeper layers of your soft tissues. It is mainly caused by bacteria that are called Group A Streptococci or, less frequent, Staph aureus. Bacterial cellulitis is also called erysipelas.

Moisture in your skin folds and the area between your toes can harm the natural barrier of your skin and allow fungi to enter. Infections with fungi can act as entry points for bacteria that, in turn, cause bacterial cellulitis. Further entry points for bacteria are injuries to your skin, such as scratches or small cuts.

Symptoms of bacterial cellulitis are pain, warmth, swelling and reddening of the skin of the affected limb. You may also notice blisters on your skin or even have fever or chills. Compression garments can worsen cellulitis, and you should remove them in the acute phase.

Cellulitis is always treated with antibiotics. It is important to take your antibiotics until all signs of bacterial cellulitis have resolved and you should not stop the therapy too early. In severe cases, you may need intravenous antibiotics at the hospital. Bacterial cellulitis can take a serious course when the infection spreads through the blood system, called blood poisoning or sepsis. The infection can spread very fast and always requires immediate treatment.

What can you do when you suspect an infection?

• Contact your healthcare professional (HCP) immediately. The sooner the treatment, the better.
• Mark the affected area with a pen. This helps you to notice any changes in the size of the infection.
• Keep an eye on the affected area and check it several times a day.
• Stop your regular lymphedema treatment (e.g. compression and Manual Lymphatic Drainage). After consultation with your HCP, you can continue with your regular treatment.
• When you receive antibiotic treatment, take the prescribed antibiotics until the end.

How can you reduce your risk of infections?

• Keep your skin clean and dry and maintain a good skin care
• Pay attention to skin folds and the area between your toes
• Clean any cuts, scrapes or insect bites • Avoid skin punctures (e.g. injections or blood samples) or other injuries at your swollen limb
• Open wounds incl. leg ulcers should be treated properly
• Keep your compression garments and bandages clean
• In some cases, it might be necessary to take antibiotics prophylactically. Your HCP will take this decision with you.

What can you do to reduce your risk of lymphedema in general

Other complications of lymphedema

Lymphedema is long-term (chronic) disease and other complications besides infections may occur.

A very rare complication of long-lasting lymphedema is the development of lymphangiosarcoma, an aggressive type of soft tissue cancer. Lymphangiosarcoma can develop years after breast removal for breast cancer treatment. It requires immediate treatment with removal of all tissue that is affected with the tumor, followed by radiation or chemotherapy, or a combination of both. Lymphangiosarcoma may also develop after other forms of lymphedema as a consequence of the weaker immune system which is linked to lymphedema in general.

Many patients with chronic diseases such as lymphedema suffer from anxiety or depression. Therefore, lymphedema treatment also aims to improve your overall well-being. Self-management, including regular exercise and movement is one way, but you may also consider psychological support.