Pelvic Cellulitis: What You Should Know

Pelvic cellulitis is a non-contagious infection that occurs in women during the postpartum period and can be life-threatening. Learn more.
Pelvic Cellulitis: What You Should Know
Maria del Carmen Hernandez

Written and verified by the dermatologist Maria del Carmen Hernandez.

Last update: 11 April, 2023

Pelvic cellulitis is a non-contagious skin infection that occurs most often in the postpartum period. It must be diagnosed and treated urgently to prevent it from spreading and becoming life-threatening. In this article, we’ll tell you everything you need to know. Keep reading!

What is pelvic cellulitis?

Cellulitis is a skin infection caused by bacteria that can lead to serious complications. The skin surface is erythematous and inflamed and sometimes warm to palpation and painful. The infection is generated by the entry of microorganisms through an open wound. It’s therefore one of the possible complications following childbirth, especially if there have been injuries to the vaginal walls or tears.

The most common causative agents are staphylococci, but streptococci can also be found. Both make up the skin flora. In addition, there are different types of postpartum infections, including the following:

  • Endometritis: An infection of the uterine lining
  • Myometritis: Involvement of the uterine muscle
  • Parametritis: This is an infection of the areas around the uterus

The causes of pelvic cellulitis

The condition most often occurs after prolonged childbirth or if forceps are used that tear the vaginal walls. Also, any wound can become infected and lead to pelvic cellulitis. This condition becomes too serious if it’s not treated promptly and correctly. In addition, women with weakened immune systems are more likely to develop it.

It can also develop as a complication of diverticulitis and Crohn’s disease or after abdominal surgery.

A woman lying on the couch with abdominal pain.
Pelvic cellulitis can follow acute appendicitis or other gynecologic procedures or infections.

Clinical manifestations of pelvic cellulitis

The most common clinical manifestations, which are usually unilateral, are as follows:

  • Elevated temperature
  • Erythematous region on the skin that tends to spread
  • Local heat
  • Edema
  • Pain and tenderness

Some local symptoms may be vaginal bleeding or discharge, tenesmus, diarrhea, or deep tenderness of one or both lower quadrants. In fact, symptoms may take several days to appear. Sometimes infections may not be noticed until after discharge from the hospital. Therefore, it’s important to look for signs of infection even after you’ve been discharged.

Diagnosis and treatment of pelvic cellulitis

A diagnosis is made based on the symptoms and signs that the woman experiences. However, a physician may request blood tests, urine tests, or biopsies, among others. As in all bacterial infections, the treatment to be started consists of oral or parenteral antibiotics according to the severity. The rapid initiation of the procedure avoids the evolution of the condition to more serious diseases, such as necrotizing fasciitis.

The pathology spreads quite easily, so emergency care should be sought in the following situations:

  • Fever
  • The presence of an erythematous rash that’s tender to the touch
  • Local warmth and swelling

Differential diagnoses

Some of the clinical manifestations observed may be found in other types of diseases. Therefore, it’s important to differentiate pelvic cellulitis from all of them:

  • Pelvic inflammatory disease
  • Diverticular disease
  • Appendicitis
  • Spontaneous abortion or sepsis following termination of pregnancy
  • Generalized peritonitis

You may be interested in: Skincare After Childbirth

A doctor pricking a woman's finger to test her blood.
Some factors can increase the likelihood of developing an infection. These may include anemia, bacterial vaginosis, obesity, prolonged labor, or a delay between delivery and rupture of the amniotic sac.

How to prevent pelvic cellulitis

The most important thing is to take the necessary precautions after delivery to avoid any complications. Some of the recommendations to prevent pelvic cellulitis are the following:

  • Maintain a balanced diet.
  • Drink plenty of fluids.
  • Get enough rest.
  • Perform adequate hygiene of the vagina.
  • Always clean from front to back after bathing.

People with underlying diseases, such as poor circulation or diabetes, should take additional care to avoid lesions on the skin surface. In turn, infections that develop postpartum occur more frequently in places with poor-quality medical care or unhygienic practices.

Risk factors for postpartum infections

The risk of developing an infection after childbirth varies greatly according to the method used to deliver the baby. Therefore, the chances of getting an infection are as follows:

  • 15 to 20 % in deliveries performed by unscheduled cesarean section, after the onset of labor
  • 5 to 15 % in scheduled cesarean deliveries, but before the onset of labor
  • 1 to 3 % in normal vaginal deliveries

Therefore, the most important risk factor for the development of postpartum infections is the type of delivery. For this reason, Obstetrics & Gynecology recommends using chlorhexidine to prepare the skin and avoid removing pubic hair with a razor, among others. Similarly, there are different added factors that can increase the likelihood of a woman developing an infection.

The importance of early diagnosis

In conclusion, pelvic cellulitis is a bacterial skin infection that can be potentially serious. Therefore, it’s best to consult a physician at the first sign of symptoms in order to start treatment and avoid complications. Otherwise, the infection can spread to the bloodstream, and lymph nodes and can be life-threatening.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992 Oct;13(10):606-8. PMID: 1334988.
  • Infections of the Uterus After Delivery. 2020 [Internet] Disponible en:
  • Conroy, K., Koenig, A. F., Yu, Y. H., Courtney, A., Lee, H. J., & Norwitz, E. R. (2012). Infectious morbidity after cesarean delivery: 10 strategies to reduce risk. Reviews in obstetrics & gynecology5(2), 69–77.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.