Cellulitis is a diffuse infection of the soft tissues with
no localized area of pus amenable to drainage. The affected area is described
as indurated (i.e., warm, red, and swollen). It is also painful. A component of
lymphangitis (infection involving the lymphatics) is indicated by red
streaking, progressing proximally from the affected area.
An abscess is a localized collection of pus, often with a
component of surrounding cellulitis (with the above signs). One sign of an
abscess is an area of fluctuance; that is, when you apply gentle digital
pressure over the area, you can push and feel a “give,” indicating the presence
of fluid underneath. Another sign is that an abscess often seems to “point;”
that is, the skin starts to thin from the pressure of the fluid underneath. The
distinction between cellullitis and abscess is important. The main treatment
for an abscess is incision and drainage (cutting into the abscess and widely
opening the abscess cavity). Cellulitis does not warrant this intervention.
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