Lymphoedema 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. 

Excess 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. You may also notice blisters on your skin or even have a fever or chill. Compression garments can worsen the symptoms of cellulitis, and you should remove them while your limb is painful.

Bacterial cellulitis is always treated with antibiotics. It is important to take your antibiotics until all signs of 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 be very serious 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 track 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 lymphoedema 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 of your prescription

How can you reduce your risk of infections?

• Keep your skin clean and dry and maintain a good skin care
• Regularly check 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 including leg ulcers should be treated. Discuss with your HCP
• 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 lymphoedema

Other complications of lymphoedema

Lymphoedema is long-term (chronic) condition and other complications besides infections may occur.

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

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