Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Jeremy Swartzberg

Jeremy Swartzberg, MD

Hospital Medicine

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Oakland Medical Center
Appt/Advice: 510-752-1190

See all office information »

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Overview

Most of the time, your skin prevents bacteria from entering your body. Cellulitis is a common infection that can occur when bacteria enters your body through a cut or scratch on your skin. The infected skin can become red, painful, tender, or swollen.

Mild cellulitis goes away on its own or can be treated with antibiotics. You are more likely to get cellulitis if you are recovering from surgery or have another health problem, such as:

  • Obesity
  • Diabetes
  • Chronic swelling in your arms or legs
  • A weakened immune system

Cellulitis can become dangerous if the infection spreads.

Call us right away if the redness and swelling are spreading or if you have:

  • Fever
  • Chills
  • Nausea
  • Vomiting

Symptoms

You may have sores or rashes, or the skin around the infection may be:

  • Red
  • Swollen
  • Warm or hot to the touch
  • Tender or painful

If the redness or swelling spreads, call us right away. It’s very important to stop cellulitis from spreading to your blood or organs.

Watch for other signs of infection:

  • Fever or chills
  • Swollen lymph glands
  • Fluid oozing from the infection
  • Feeling ill or very tired
  • Tight, stretched-looking skin
  • Aches or swelling in the joints
  • Nausea or vomiting

Adults usually have cellulitis on their arms, legs, or face. Children usually have it around their eyes or anus.

Symptoms that affect the eye. Cellulitis around the eye or in the eye socket (orbit) is called orbital cellulitis. This serious infection occurs most often in children. It must be treated immediately.

Diagnosis

We usually diagnose cellulitis by giving you a physical exam and asking about your symptoms. Tell us about any recent injuries or skin problems, even if they seem minor.

We may draw a line around the red area on your skin and check the line every 24 hours. This tells us whether the infection is spreading. After you begin treatment the redness may continue to spread for a day or so.

Causes and Risk Factors

Cellulitis:

  • Is caused by bacteria (usually Staphylococcus or Streptococcus) that enters your body through a cut or break in your skin that may be too small for you to notice.
  • Infects the tissues below your skin.

Cellulitis can start in skin that is:

  • Cracked or peeling.
  • Affected by athlete’s foot or jock itch.
  • Irritated by clothing or shoes.
  • Broken by insect stings or animal or human bites.
  • Affected by eczema, acne, or psoriasis.

Your risk for cellulitis is higher if you have:

  • Recently had surgery.
  • An illness or take a medication that weakens your immune system or causes blood circulation problems. 

You can also get cellulitis through contact with raw meat, soil, or other substances that carry bacteria.

Treatments

With proper treatment and self-care, your cellulitis will probably get better within 7 to 10 days.

We recommend that you:

  • Get plenty of rest.
  • Keep your body and clothing clean.
  • Keep the infected area clean and protected.

If you need antibiotics, we:

  • Usually prescribe 7 to 10 days of medication that you take by mouth.
  • Use intravenous (IV) antibiotics for severe infections, or if you don’t get better with oral medication.

Antibiotic treatment may take longer to work if you have a:

  • Chronic illness
  • Weakened immune system
  • Severe case of cellulitis

We can recommend pain medication if needed.

To reduce swelling, prop the swollen area on pillows so that it’s higher than the level of your heart.

Surgery may be needed to drain an abscess caused by cellulitis.

Prevention

The best way to avoid cellulitis is to take good care of your skin. To prevent breaks, cuts, and scratches:

  • Use lotion or ointment that’s designed to keep your skin moist and prevent cracking.
  • Don’t scratch itchy or dry skin.
  • Wear well-fitting shoes that don’t cramp your feet.
  • Wear protective clothing and gear for work or sports.
  • Check your feet and skin daily for sores if you’re diabetic.
  • Treat fungal infections, such as athlete’s foot, right away.

When you have a cut or break in the skin: 

  • Clean it carefully with soap and water.
  • Cover it with a bandage.
  • Change the bandage daily until a scab forms.
  • Watch for redness, pain, drainage, or other signs of infection.

Please let us know if you have questions about keeping your skin healthy.

Complications

If cellulitis has spread to your organs or blood, you may need IV antibiotic treatment. Cellulitis can be life-threatening at this level.

Very rarely, we may need to treat and monitor you in the hospital. This may be necessary if you have:

  • An infection that has spread to your blood, lymph nodes, or organs.
  • A high temperature.
  • Blood pressure problems.
  • Nausea and/or vomiting.
  • A weak immune system because of a condition like cancer.
  • Infection in your eyes.

Your Care with Me

As your hospital medicine physician, my first contact with you will be either in the Emergency Department or in your hospital room.  Together we will go over your medical history and medications you are currently taking, perform a physical examination, and come up with a treatment plan.

While you are in the hospital

I will work closely with your bedside nurse and patient care coordinator each day of your stay to improve your health and to plan for a safe return home. We will also inform your family members of your care plan. If you are having symptoms that concern you when you are in the hospital, please inform me or one of the hospital staff immediately.

If specialty care is needed during your hospital stay, I may contact one of my specialty colleagues and discuss your care with them.

If I prescribe medications

During your hospital stay, we will work together to monitor and assess how your medications are working and make adjustments over time. Before you leave, we will go over each new medication, how to take it, and when/if to stop the medication. At the time of discharge, all medications can be picked up at the discharge pharmacy. 

After you are discharged from the hospital, you will have a follow up visit with your primary care clinician. You may also receive a follow up phone call from one of the hospital staff to see how you are doing once you are at home.

If you are having symptoms that concern you and you are not currently in the hospital:

  • You may contact your personal physician, who will evaluate your health and symptoms.
  • If you have urgent concerns or issues or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice and make an appointment with your doctor if needed.  
  • If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system that allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate. When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

This applies especially to your primary care physician, who will be notified electronically when you are hospitalized, and may review the care you are receiving while in the hospital. Upon discharge, your doctor will receive a summary of your care in the hospital, including some tests or imaging results that may still be pending.

Care After Hospital Discharge

If you require further testing and medications, or are having symptoms after leaving the hospital, we recommend that you contact your primary care physician.
You can also call the Appointment and Advice line. Our call centers are open every day of the year around the clock. If you need advice, we will transfer you to one of our skilled advice nurses (RNs). They can help you determine when you need to be seen and in what location. The advice nurse can often start your treatment by telephone depending on the situation and has access to your electronic medical record.

If refills are needed in the future after you leave the hospital, you can:

  • Contact your primary care physician.
  • Order them online or by phone.
  • Order future refills from my home page or your primary care physician’s home page.
  • Order by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost.
  • Or pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact your primary care physician regarding your prescription.
If further lab testing or imaging is needed 

For lab tests that are needed after discharge, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. Your primary care physician will follow up on these results unless your condition needs immediate attention. In addition, you can view most of your laboratory results online, along with any comments that your primary care physician may have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, I will make an electronic referral to the appropriate department and they will contact you for an appointment.

If Surgery or a Procedure is a Treatment Option

Occasionally, a procedure and/or surgery can be postponed until you are healthier and have recovered from your hospitalization. Then I will refer you to the appropriate service and they will follow up with you once you are discharged from the hospital.

If you are considering a procedure or surgery, please take a moment to go to the “Tools & Classes” tab above and select the “Prepare for Your Procedure - Emmi” link. There you can watch videos about different procedures.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages to your primary care physician and specialist.
  • Manage your prescriptions.
  • View your past visits and test results. View your preventive services to see whether you are due for a routine screening or updated immunization.
  • Manage your family’s health by setting up access to act on their behalf. Learn how to coordinate care for the ones you love.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures of common conditions we take care of in the hospital.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate Health Education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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