What should you know about crepitant cellulitis?

Cellulitis involves infection in deeper layers of skin and soft tissue. Crepitus means a clinician may feel or hear a crackling sensation when the affected area is gently examined; it can reflect gas in tissues and is not a routine feature of a mild skin irritation. The area may also be warm, swollen, red, and painful. Fever can occur, but its absence does not make a rapidly changing or unusually painful area safe to watch at home.

Entry points can include a cut, wound, ulcer, injection site, or fungal infection such as [Athlete's Foot](/conditions/athletes-foot/). People with [Type 2 Diabetes](/conditions/type-2-diabetes/) or reduced immunity may need especially prompt evaluation. This condition is different from uncomplicated [Cellulitis](/conditions/cellulitis/).

Treat suspected crepitant cellulitis as an emergency. Go to an emergency department or contact urgent medical services immediately, particularly if redness is spreading, pain is severe, or the skin is becoming dusky, blistered, or numb. Do not massage the area, puncture blisters, apply irritant creams, or wait for a routine appointment. Keep the area protected, note when the changes began, and take a list of medicines and medical conditions with you.

Hospital assessment may include examination, blood tests, and imaging. Treatment can require intravenous antibiotics, close monitoring, and a surgical opinion if infected or damaged tissue must be removed. Only an examining clinician can distinguish this process from other causes of swelling or crackling.

Seek emergency care now for crackling beneath red or swollen skin, rapidly increasing pain or swelling, fever, confusion, faintness, fast breathing, or marked weakness. These warning features can signal a spreading infection or [Sepsis](/conditions/sepsis/). Do not use how common or uncommon a symptom seems to decide whether to go.

Ask what may have allowed infection to enter, whether imaging or surgery is needed, which warning signs should be reported during treatment, and how a wound or fungal infection will be managed.