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Updated: June 23, 2025
There were well-marked evidences of peritonitis and cellulitis. Old-time surgeons had considerable difficulty in extracting arrow-heads from persons who had received their injuries while on horseback.
In the human subject, multiplication in the blood-stream does not occur to any great extent. In some general acute pyogenic infections, such as osteomyelitis, cellulitis, etc., pure cultures of staphylococci or of streptococci may be obtained from the blood. In pneumococcal and typhoid infections, also, the organisms may be found in the blood.
Cellulitis of the sole of the foot may follow whitlow of the toes. In the region of the ankle cellulitis is not common; but around the knee it frequently occurs in relation to the prepatellar bursa and to the popliteal lymph glands, and may endanger the knee-joint.
Some combinations, for example, result in a rapidly spreading cellulitis with early necrosis of connective tissue accompanied by thrombosis throughout the capillary and venous circulation of the parts implicated; other combinations cause great œdema of the part, and others again lead to the formation of gases in the tissues, particularly in the muscles.
In the region of the elbow-joint, cellulitis is common around the olecranon. It may originate as an inflammation of the olecranon bursa, or may invade the bursa secondarily. In exceptional cases the elbow-joint is also involved.
The inflammation affects chiefly the walls of the vessels, and is attended with clotting of the lymph. There is also some degree of inflammation of the surrounding cellular tissue peri-lymphangitis. One or more abscesses may form along the course of the vessels, or a spreading cellulitis may supervene.
#Infective bursitis# frequently follows abrasions, scratches, and wounds of the skin over the prepatellar or olecranon bursa, and in neglected cases the infection transgresses the wall of the bursa and gives rise to a spreading cellulitis.
Repeated hæmorrhages into a joint may result in appearances which closely simulate those of tuberculous disease. Recent hæmorrhages into the cellular tissue often present clinical features closely resembling those of acute cellulitis or osteomyelitis.
Infection always takes place through a breach of the surface, although this may be superficial and insignificant, such as a pin-prick, a scratch, or a crack under a nail, and the wound may have been healed for some time before the inflammation becomes manifest. The cellulitis, also, may develop at some distance from the seat of inoculation, the organisms having travelled by the lymphatics.
Recovery does not take place until the dead bone is removed, and the usefulness of the finger is often seriously impaired by fibrous or bony ankylosis of the interphalangeal joints. This may render amputation advisable when a stiff finger is likely to interfere with the patient's occupation. Cellulitis of the forearm is usually a sequel to one of the deeper varieties of whitlow.
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