Skin Infections: An Updated Review of Cellulitis and Impact of Climate Change.

Abstract

Background: Cellulitis, a bacterial infection affecting the dermis and subcutaneous tissues, presents with redness, warmth, swelling, and tenderness. It is a significant concern in skin and soft tissue infections (SSTIs) and is often caused by beta-hemolytic streptococci and methicillin-sensitive Staphylococcus aureus. Risk factors include diabetes, obesity, and venous insufficiency. While traditionally managed with antibiotics targeting streptococcal species, the rise of methicillin-resistant Staphylococcus aureus (MRSA) complicates treatment. In the U.S., cellulitis accounts for significant healthcare burdens, with millions of cases annually. Emerging evidence suggests climate change may influence cellulitis incidence due to elevated temperatures and seasonal fluctuations.

Methods: This review investigates the relationship between climate change, particularly rising temperatures, and cellulitis incidence. Studies were examined for correlations between temperature, humidity, and cellulitis rates, with a focus on global trends and seasonal patterns. Data from various regions were analyzed to explore the potential impact of climate factors such as humidity, rainfall, and the occurrence of tropical cyclones on cellulitis prevalence.

Results: Higher temperatures, particularly in summer, were consistently linked to increased cellulitis cases, with a dose-dependent relationship between temperature rise and infection rates. Studies from diverse climates, including the U.S., Taiwan, the UK, and Australia, confirm that cellulitis cases peak in warmer months, and a 5°F increase in temperature correlates with a higher likelihood of hospitalization. Furthermore, tropical cyclones and floods exacerbate the condition by increasing skin trauma and providing favorable conditions for bacterial growth, especially Vibrio infections.

Conclusion: Cellulitis incidence is influenced by climate factors, particularly elevated temperatures and humidity, which promote bacterial colonization and skin vulnerability. Future climate change may exacerbate this trend, emphasizing the need for preventative strategies. Healthcare systems must prepare for the growing impact of climate-related cellulitis cases, particularly in high-risk populations.