Lymphedema and infections

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 frequently, Staph aureus. Bacterial cellulitis is also called erysipelas.

Moisture in your skin folds and in 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 discuss further treatment with your Healthcare Professional.

Cellulitis is always treated with antibiotics. It is important to take your antibiotics as advised by your Healthcare Professional. 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 – known as blood poisoning or sepsis. The infection can spread very fast, and always requires immediate treatment.

• Contact your Healthcare Professional immediately. The sooner you get 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).
• When you receive antibiotic treatment, take the prescribed antibiotics as advised.

• Keep your skin clean and dry and maintain 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 on your swollen limb.
• Open wounds including leg ulcers should be treated properly.
• Keep your compression garments and bandages clean.
• In some cases, it may be necessary to take antibiotics prophylactically. Your Healthcare Professional will provide advice on this.

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

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 due to 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.