Can you make the diagnosis?

Michael is putting on his socks when he notices a red bump on his foot.  It is a bit painful and itchy, and he wonders if it is a spider bite from cleaning out his garage over the weekend.

At work that day, he notices the area is getting more painful when he walks, and it seems like it is rubbing against his shoe.  It seems to feel better if he puts his foot up on his desk.  By the end of the day, his whole leg seems to be hurting, and he feels feverish.

That night at home, he can’t wait to get his shoes and socks off because of the pain.  But what he sees next surprises him:


What is Michael’s diagnosis?

  1.  Brown recluse spider bite
  2. Cellulitis
  3. Shingles
  4. Allergic reaction



If you guessed 2.  Cellulitis, you are right!

Cellulitis occurs when bacteria, often staph or strep, enter a break in the skin.  People often recall a bug bite or a minor injury, then notice increased redness, swelling, and pain.  As the infection worsens, it can travel up the lymph system, called “lymphangitis”, but it used to be called “blood poisoning”.

The treatment for cellulitis is antibiotics.  Cellulitis can be serious, and when it occurs the patient should be seen medically as soon as possible.  It is often associated with fever, and can result in sepsis if the bacteria enters the blood stream.

Brown recluse spider bites are rare, and can cause redness, pain, and ulceration at the site of the bite.  This can look like cellulitis.  Shingles rash is a good guess, but the rash of shingles usually has little blisters called “vesicles”, that looks like the chicken pox rash.  An allergic reaction would often be more widespread over the body, and looks like hives.

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