An Article By Cecilia Brennan, Podiatrist – New Step Podiatry.
Cellulitis and Sepsis: Why Foot Infections Should Never Be Ignored
Most people don’t think a cracked heel, blister or ingrown toenail could lead to a hospital admission.
However, these seemingly minor foot problems can sometimes create an entry point for bacteria, leading to cellulitis, a skin infection that can spread quickly if left untreated.
While most cases of cellulitis respond well to antibiotics, delays in treatment can increase the risk of serious complications. In rare cases, cellulitis can contribute to sepsis, a life-threatening medical emergency.
Understanding the signs of cellulitis and knowing when to seek help can make a significant difference to your health and recovery.
What Is Cellulitis?
Cellulitis is a bacterial infection that affects the deeper layers of the skin and the tissue beneath it.
It commonly appears as an area of redness, warmth, swelling and tenderness. The skin may look shiny, feel tight or become increasingly painful over a short period of time.
Cellulitis can occur anywhere on the body, but it frequently affects the feet and lower legs.
Some people may also develop symptoms such as fever, chills or feeling generally unwell.
Unlike a simple skin irritation, cellulitis tends to spread. The area of redness often becomes larger over time and symptoms can worsen quickly if treatment is delayed.
Who Can Get Cellulitis?
Cellulitis can affect anyone.
Although people with diabetes, poor circulation, lymphoedema or a weakened immune system may have a higher risk, healthy adults and children can also develop cellulitis.
The common factor is usually a break in the skin that allows bacteria to enter.
Many patients are surprised to learn that cellulitis can develop from something that initially seemed minor.
What Causes Cellulitis?
Bacteria need a way to enter the body, and the feet provide several opportunities.
Common causes include:
- Cracked heels
- Dry or split skin
- Athlete’s foot / tinea
- Blisters
- Cuts and grazes
- Insect bites
- Ingrown toenails
- Nail infections
- Foot ulcers
- Wounds
Sometimes the break in the skin is so small that people cannot identify how the infection started.
This is one reason why foot health is so important. Looking after your skin, toenails and footwear can help reduce the risk of infection developing in the first place.
Why Early Treatment Matters
Cellulitis should never be a “wait and see” condition.
The infection can spread rapidly through the skin and surrounding tissues. What starts as a small patch of redness on the foot can sometimes spread up the leg within hours or days.
When cellulitis is recognised early, treatment is usually straightforward and often involves a course of oral antibiotics prescribed by a doctor.
However, delaying treatment can increase the risk of complications and may result in hospitalisation for intravenous antibiotics.
The sooner treatment begins, the better the outcome is likely to be.
How Can Cellulitis Lead to Sepsis?
One of the reasons healthcare professionals take cellulitis seriously is because infections can sometimes spread beyond the skin.
In some cases, the body’s response to an infection becomes overwhelming and triggers sepsis.
Sepsis is a life-threatening condition that occurs when the body’s response to an infection begins to damage its own tissues and organs.
Many people associate sepsis with infections acquired in hospital, but around 80% of sepsis cases actually develop in the community.
Sepsis can develop from bacterial, viral or fungal infections and may begin in the lungs, urinary tract, abdomen, skin or other parts of the body.
This means that a skin infection such as cellulitis has the potential to become much more serious if left untreated.
Infections can begin through cuts, wounds, cracked skin, surgical incisions or other seemingly minor injuries. While most people with cellulitis will never develop sepsis, it is important to understand why healthcare professionals encourage early assessment and treatment.
In 2022-23 alone, more than 84,000 Australians were hospitalised with sepsis.
What Are the Signs of Sepsis?
Sepsis is a medical emergency.
If you have cellulitis or another infection and begin feeling significantly unwell, seek urgent medical attention.
Symptoms may include:
- Fever
- Chills or shivering
- Rapid heart rate
- Fast breathing or shortness of breath
- Dizziness or feeling faint
- Nausea or vomiting
- Confusion
- Extreme fatigue or weakness
- Severe or worsening pain
The Australian Sepsis Network encourages people to ask: “Could it be sepsis?” Recognising the warning signs and acting quickly can save lives.
When Should You Seek Medical Attention?
If you notice redness, swelling, warmth or pain that is spreading, seek medical advice as soon as possible.
Do not wait several days to see if the problem settles on its own.
Try to arrange a prompt appointment with your GP or attend a Walk In Centre for assessment.
If you develop fever, chills, confusion, difficulty breathing or feel significantly unwell, you should attend the Emergency Department immediately.
How Can a Podiatrist Help?
Many cases of cellulitis affecting the feet begin with conditions podiatrists manage every day.
These include cracked heels, athlete’s foot, ingrown toenails, wounds, ulcers and nail infections.
Treating these problems early can help reduce the risk of bacteria entering the skin and causing infection.
For people with diabetes, regular podiatry care is particularly important. Reduced sensation in the feet can make it difficult to notice injuries or infections before they become serious.
How Can You Reduce Your Risk of Cellulitis?
Looking after your feet is one of the most effective ways to reduce your risk of cellulitis.
Some simple preventative measures include:
- Moisturising dry or cracked skin
- Treating athlete’s foot promptly
- Cleaning and covering cuts or wounds
- Wearing well-fitting footwear
- Checking your feet regularly
- Seeking treatment for ingrown toenails
- Managing swelling in the legs and feet
- Attending regular foot health checks if you have diabetes
Small foot problems are often easier to treat than the complications that can develop when they are ignored.
Learn More About Sepsis
Most people are familiar with the warning signs of a heart attack or stroke, but awareness of sepsis remains surprisingly low. Despite being a major global health issue, many people do not know what sepsis is, how it develops or what symptoms to look for. This lack of awareness can lead to delays in seeking medical treatment, which can have serious consequences when an infection is progressing rapidly.
Sepsis is the body’s extreme response to an infection and can develop from many different types of infections, including skin infections such as cellulitis. While most cases of cellulitis are treated successfully with antibiotics, understanding the signs of sepsis helps people recognise when an infection may be becoming more serious. Early recognition and treatment are critical and can significantly improve outcomes.
The Australian Sepsis Network (Sepsis Australia) is working to improve awareness, education and early recognition of sepsis across Australia. Their goal is to help both healthcare professionals and the wider community identify sepsis sooner, because earlier treatment can save lives. They provide a range of evidence-based resources for patients, families, carers and clinicians, helping Australians better understand the risks, warning signs and long-term impacts of sepsis.
One of their key messages is simple but powerful: “Could it be sepsis?” If you would like to learn more about sepsis, its warning signs and the important work being done to improve outcomes across Australia, we encourage you to visit the Australian Sepsis Network website and explore the resources available. Increased awareness can help ensure more people receive the care they need before an infection becomes life-threatening.
Have You Delayed Getting a Foot Problem Checked?
Our podiatrists are here to ensure those in Canberra have access to quality services that can help individuals get the treatment they deserve.
