Topic Progress:


The assessment process is vital. An accurate, clear history and timeline that details the start of symptoms from the patient and/or carer assists with a correct diagnosis that enables safe and effective treatment.

(Sutherland & Parent, 2017)

  • When did it start?
  • How did it start/how do you feel?
  • Fever/headache/night sweats
  • General malaise
  • Where did it manifest first?
  • Skin condition
  • Skin breaches; trauma, insect bites, tinea, recent surgery
  • Identify entry site – may be visible but may need to question patient about recent activities such as gardening etc. to identify entry route
  • Mark area suspected and check for spreading inflammation or erythema
  • Monitor pain level - patient may describe intense pain which increases as infection spreads
  • Check for signs of oedema - as infection increases, limbs may become swollen and oedematous
  • Check for blistering
  • Monitor blood results – CRP will be increased when there is inflammation in soft tissues and white cell count will be raised when infection is present

(Beldon, 2011; Sutherland & Parent, 2017; CKS NICE, 2023)

As part of the comprehensive assessment, comorbidities and risk factors should be taken into consideration.

  • Skin conditions of the lower legs such as:
    • gravitational eczema
    • leg ulcers
    • lymphoedema
    • tinea
    • trauma
  • Previous episodes of cellulitis
  • Obesity
  • Immunocompromised patients
  • Chronic disease such as:
    • diabetes mellitus
    • chronic liver disease
    • renal disease
  • Pregnancy

(Sutherland & Parent, 2017; PCDS, 2023)