Where follow-up fits after a skin infection
Infected wound and cellulitis follow-up is the care that comes after a clinician has diagnosed a skin infection and started treatment, often with antibiotics. It means checking that the infection is responding, caring for the wound that is still open, and working on the reasons the infection started.
Cellulitis is a bacterial infection of the skin and the tissue just beneath it. The area turns red or darker than usual, swollen, warm and tender. It usually begins where bacteria got in through a break in the skin: a wound, an ulcer, a crack between the toes, an insect bite. A wound can also become infected without widespread cellulitis. Gateway arranges follow-up for both with partner clinicians across Greater St. Louis and the Metro East.
If you are looking for help with this wound close to home, start with our overview of wound care in St. Louis.
Urgent signs that should not wait for a visit
Skin infections can worsen fast. Call 911 for:
- Confusion, extreme drowsiness or fainting
- Trouble breathing or a racing heartbeat
- Severe pain that seems out of proportion to how the skin looks
- Skin turning purple, gray or black, or new blisters filled with dark fluid
- Redness spreading over a matter of hours, especially with high fever and shaking chills
Contact the prescribing clinician promptly, without waiting for a scheduled visit, for:
- Redness that moves past the line marked on your skin
- Fever or chills
- Red streaks traveling up the arm or leg
- More pain, swelling, pus or odor
- Vomiting or being unable to keep medicine down
- A rash, severe diarrhea or another reaction after starting an antibiotic
Gateway is not an emergency service.
What to expect while cellulitis improves
Improvement is gradual. Fever and the general unwell feeling usually ease first. Redness and swelling follow more slowly, which is why clinicians often outline the red area with a pen.
As the infection clears, skin can look bruised, dry or flaky and may peel. Swelling in a leg can linger after the infection has been treated. Ask the prescriber what you should expect to see and by when.
Infected wounds and wounds that are only slow
Every open wound has bacteria on its surface, and that alone is not an infection. Infection means the bacteria are harming tissue. Clues include new or rising pain, more drainage, a change in drainage color, odor, warmth, swelling, and a wound that stalls or gets bigger. In people with diabetes or poor circulation, the signs can be faint.
The treating clinician decides whether a wound is infected and what to do about it. That may include a culture, removal of dead tissue, a change in dressings, medicine or imaging. Our guides on the signs of wound infection and on what wound drainage means explain what to watch for and how to describe it. Infections in a surgical incision have their own page on surgical site infections.
What an infection follow-up visit covers
At each visit the treating clinician looks for change:
- Comparing redness, swelling and warmth with the last visit or the marked line
- Measuring the wound and noting drainage, odor and tissue color
- Asking how you are tolerating the prescribed medicine and about any missed doses
- Reviewing any culture or lab results
- Deciding whether the plan should continue, change or move to a higher level of care
Gateway handles records, visit scheduling and supplies, and passes updates to the clinician who prescribed treatment and to your primary care clinician. Ongoing infection monitoring and follow-up can continue while the wound remains open.
Lowering the chance of another infection
Cellulitis tends to return when the conditions that let it start are still there. Follow-up is a good time for the clinician to look at them:
- Leg swelling or lymphedema, which makes skin fragile and slower to clear infection
- Dry, cracked skin and fungal infection between the toes
- A chronic wound that remains open
- Diabetes and circulation problems
Gateway can coordinate lymphedema and edema management when the clinician orders it. Our guide on swelling in the legs and wounds explains the connection.
How to arrange follow-up through Gateway
Patients, families and caregivers can call 314-325-0126 with or without a referral, or request care. The form collects a name and phone number only.
It helps to know the name of the medicine that was prescribed, the date it was started and who prescribed it. Visits take place in homes, skilled nursing, assisted living and other settings. We confirm availability for each location and setting, and coverage depends on the treating provider, your plan and the care needed.
Common questions
How do I know if the treatment is working?
Signs that point the right way include less pain, no fever, redness that stays inside the marked line and then shrinks, and swelling that slowly goes down. If the redness is spreading, the pain is rising or you feel sicker, contact the prescribing clinician without waiting for the next scheduled visit.
Why did the clinician draw a line on my skin?
The line marks where the redness ended at the time of the exam. It gives you, your family and the next clinician a fixed point to compare against. If the redness moves past the line, contact the clinician who prescribed your treatment.
Is every red, swollen leg cellulitis?
No. Several conditions look similar, including skin changes from vein disease, a blood clot, gout and a reaction to a dressing or cream. Redness in both legs at once is often related to swelling and vein problems. Only an exam by a clinician can sort this out. Sudden swelling and pain in one leg should be evaluated urgently.
Who do I call if it gets worse at night or on a weekend?
Use the after-hours number for the clinician or practice that prescribed your treatment, or go to an urgent care or emergency department. For any of the emergency signs listed above, call 911. Gateway is not an emergency service. Let us know afterward so the wound care team has the update.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.