Pathophysiology

A bacterial infection may enter the soft tissues from virtually any skin violation. Patient risk is increased by immunosuppression, alterations in vascularity (e.g., previous radiation treatment), underlying systemic disease (e.g., diabetes), and the presence of foreign bodies or appliances precluding normal host defenses. A remote history of silicone injections may predispose to recurrent episodes of cellulitis. 1

The most likely pathogens causing facial cellulitis include Haemophilus influenzae type b, Streptococcus pneumoniae, Strep. pyogenes, Strep. viridans, Staphylococcus aureus, Bacteroides fragilis, B. melaninogenicus, and other pathogens found in deep neck abscesses.2

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