Can cellulitis kill you

Treatments Your Physician May Prescribe

Although your physician may easily diagnose cellulitis, he or she may wish to order other tests such as blood work or skin biopsy. In addition, your doctor may wish to perform a bacterial culture in order to discover the particular organism that may be causing the cellulitis.
The procedure involves:

  1. Penetrating any blisters or pus-filled pockets with a needle, scalpel, or lancet.
  2. Rubbing a sterile cotton-tipped applicator across the skin to collect the sample.
  3. Sending the specimen away to a laboratory.

Typically, the laboratory will have preliminary results within 48–72 hours if there are many bacteria present. However, the culture may take a full week or more to produce final results. In addition to identifying the strain of bacteria that is causing the cellulitis, the laboratory usually performs antibiotic sensitivity testing in order to determine the medications that will be most effective in killing off the bacteria.
While waiting on the results from the bacterial culture, your doctor will probably want to start you on an antibiotic to fight the most common bacteria that cause cellulitis. Once the final culture results have returned, the physician may change the antibiotic you are taking, especially if you are not improving.
Mild cases of cellulitis in otherwise healthy persons can be managed on an outpatient basis with oral antibiotic pills. Common oral antibiotics that are used to treat cellulitis include:

  • Dicloxacillin
  • Cephalexin
  • Trimethoprim-sulfamethoxazole
  • Clindamycin
  • Linezolid

However, ill-appearing people or those who have other underlying illnesses may be hospitalized for observation and for the administration of intravenous antibiotics. Common intravenous antibiotics that are used in a hospital setting to treat cellulitis include:

  • Nafcillin
  • Oxacillin
  • Cefazolin
  • Vancomycin
  • Linezolid

If your doctor prescribes antibiotics, be sure to take the full course of treatment. In addition to prescribing antibiotics, your doctor will likely want to make sure that your underlying medical problems, if any, are being adequately managed.

9 Fast Facts About Cellulitis

If you don’t know much about cellulitis — or you’ve never even heard of it — here are a few fast facts to bring you up to speed on this potentially dangerous skin infection.

Staphylococcus aureus bacteria, pictured here, is a common cause of cellulitis. Getty Images

Cellulitis is a bacterial skin infection that can develop quickly and advance rapidly. It affects about 14.5 million people in the United States every year. (1)

Signs and symptoms of cellulitis include skin redness, pain, tenderness, and warmth. Severe infections may additionally cause blisters, nausea, fever, and confusion. (2)

Cellulitis can occur in both children and adults, and it’s not an infection you can treat yourself. If you suspect you have cellulitis, see your doctor or a dermatologist without delay. Most likely you’ll receive a prescription for oral antibiotics, but in some cases, intravenous antibiotics must be given in a hospital. (3)

Learn what raises your risk of developing cellulitis and how you can avoid it.

1. Cellulitis Is Most Often Caused by Staph or Strep Bacteria

Both Staphylococcus and Streptococcus bacteria can live harmlessly on the skin, but when there’s a break in the skin, they can cause a few different types of infections, including cellulitis. (1)

Another type of bacteria that can cause cellulitis is Pasteurella multocida, which is most commonly transmitted to humans from an animal scratch or bite. (4)

2. Any Break in the Skin Opens the Door to Cellulitis

While most cuts, scrapes, blisters, and bugbites don’t lead to cellulitis, any opening in the skin can, under the right circumstances. Such circumstances include the presence of infection-causing bacteria in the wound, but since bacteria are invisible to the naked eye, you can’t tell by looking whether a minor injury may develop into a major infection.

Some of the other factors that raise the risk of cellulitis include:

  • Inadequate wound cleaning
  • A weakened immune system
  • Reduced blood flow to the infected area
  • Impaired lymphatic drainage in the infected area

To reduce the risk of developing cellulitis, wash all minor wounds with soap and water as soon as possible, cover cuts and scrapes with gauze or an adhesive bandage to protect the wound, and check wounds daily for signs of infection and healing.

If you see a wound getting worse rather than better, consider seeing a doctor, particularly if you have diabetes.

3. Cellulitis Is Not the Same as Cellulite

Some people confuse cellulitis with cellulite, but they are two completely different conditions.

“Cellulite is often a cosmetic concern, and it develops when there’s fibrous tethering of the upper layer of the skin to the underlying muscle,” explains Anna Guanche, MD, a board-certified dermatologist who specializes in cosmetic procedures in Calabasas, California.

“As fat increases in the area, it isn’t evenly distributed due to the tight tethers, leading to a bumpy or dimpled appearance,” Dr. Guanche says.

Cellulitis, on the other hand, is a bacterial infection of the skin, often appearing as a warm, red, tender, swollen area, Guanche says.

Cellulite does not require medical treatment; cellulitis does.

4. A History of Cellulitis Increases Your Risk for Getting It Again

Having cellulitis one time increases your risk for getting it again, but steps can be taken to reduce that risk. (2)

Start by following your doctor’s instructions for treating your initial infection, including completing your course of antibiotics. (5) Antibiotics are usually prescribed for 10 to 14 days, but you might start to feel better after day three. Some people make the mistake of stopping their antibiotics too soon, but if you don’t finish the series, you may not completely kill the bacteria, and the infection could return.

In addition, take measures to reduce skin injuries. Wear protective gear when playing sports and working outdoors, wear sunscreen to prevent a sunburn, limit contact with unfamiliar animals, and apply insect repellent to avoid bug bites. (6)

If you get a wound of any kind, clean it thoroughly with warm, soapy water to rinse out dirt and bacteria. Also be sure to wash your hands before caring for your own wound or the wounds of others. Apply a topical antibiotic ointment to minor skin injuries and keep any injury covered with a bandage until it fully heals, changing the bandage daily. (2,6)

Washing your hands regularly to remove germs and bacteria may also help to prevent recurrent skin infections.

Even if you take the above measures, cellulitis can recur. If you have more than three or four infections within a 12-month period, your doctor may recommend a low-dose antibiotic as long-term maintenance therapy to prevent future infections. (6)

5. Cellulitis Isn’t Usually Contagious

Even though cellulitis is a bacterial skin infection, it generally doesn’t spread from person to person, says Barbara Bergin, MD, a board-certified orthopedic surgeon at Texas Orthopedics, Sports, and Rehabilitation Associates in Austin, Texas. (7)

The possible exceptions are if the person exposed has an open wound or there’s direct skin-to-skin or skin-to-surface contact, Dr. Bergin notes.

Therefore, if you have cellulitis, you don’t have to worry too much about passing it to family members or friends, but you should still make sure no one touches any open wounds on your body with bare hands or skin.

6. Cellulitis Can Occur Anywhere on the Body

Cellulitis can occur anywhere on the body. However, some parts of the body are more prone to these infections than others. Tsippora Shainhouse, MD, a board-certified dermatologist in the Los Angeles area and a clinical instructor at the University of Southern California, says that in adults the extremities (legs, feet, arms, and hands) are the most common sites. (2)

In children, on the other hand, cellulitis is more likely to occur on the face and neck. (2)

When cellulitis involves the fat and muscle around the eye, it’s called orbital cellulitis.

When it involves the skin around the eye and eyelids, it’s called periorbital or preseptal cellulitis. (8)

Dr. Shainhouse notes that cellulitis often occurs only on one side of the body at a time.

7. Cellulitis Can Be Life-Threatening

Most cases of cellulitis respond well to treatment, and symptoms start to disappear within a few days of starting an antibiotic. (5) But if left untreated, cellulitis can progress and become life-threatening.

“The primary concern for a case of cellulitis is sepsis, which is an infection in the bloodstream that can lead to shock or death,” says Guanche.

Signs and symptoms of sepsis include extremely low blood pressure, a rapid heart rate, dizziness, and loss of consciousness. Treatment involves hospitalization and intravenous antibiotics. (9)

Some other possible life-threatening complications of cellulitis include osteomyelitis (infection of the underlying bone) and necrotizing fasciitis, the “flesh-eating” disease that destroys soft tissue, sometimes leading to loss of limbs or even death. (10)

8. Diagnostic Tests Aren’t Often Required for Cellulitis

In most cases, your doctor won’t need to perform diagnostic testing to determine whether you have cellulitis. It is typically confirmed simply by looking at the skin. (5)

In the event that suspected cellulitis doesn’t respond to an antibiotic, your doctor may perform testing on a follow-up visit.

This might include a blood culture or a complete blood count (CBC) to check for the presence of bacteria. Or your doctor may perform a bacterial culture to identify the type of bacteria responsible for the infection. A skin biopsy can often confirm or rule out another skin disorder. (3,5,7)

9. Getting a Tattoo Puts You at Risk for Cellulitis.

Getting a tattoo in a studio with properly sterilized equipment and other hygiene measures in place is normally safe. But because a tattoo breaks the skin’s barrier, there’s also the risk of bacteria getting into the skin and causing a skin infection such as cellulitis. (11) For this reason, it’s important to take care of your skin before and after a tattoo.

Bergin — who has seen infected tattoos and piercings — recommends cleaning your skin before getting a tattoo with a skin cleanser like Hibiclens or its generic equivalent, chlorhexidine, available at most drugstores.

“I have my patients wash their extremities with this the night before and the morning of their surgery,” she says. “We use it again to scrub the operative site right before surgery and before the final prep, which is actually done in the operating room.”

She also suggests going a step further and bringing a bottle of rubbing alcohol with you to the tattoo parlor.

“Rubbing alcohol will kill just about anything on any surface. Carry a little spray bottle of it with you to the shop, or better yet, ask your artist about their sterile precautions,” she urges. “If they get all hot and bothered about your query, go somewhere else. It’s your skin.”

Cellulitis

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Medically reviewed by Drugs.com. Last updated on Sep 24, 2019.

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WHAT YOU NEED TO KNOW:

Cellulitis is a skin infection caused by bacteria. Cellulitis may go away on its own or you may need treatment. Your healthcare provider may draw a circle around the outside edges of your cellulitis. If your cellulitis spreads, your healthcare provider will see it outside of the circle.

DISCHARGE INSTRUCTIONS:

  • You have sudden trouble breathing or chest pain.

Return to the emergency department if:

  • Your wound gets larger and more painful.
  • You feel a crackling under your skin when you touch it.
  • You have purple dots or bumps on your skin, or you see bleeding under your skin.
  • You have new swelling and pain in your legs.
  • The red, warm, swollen area gets larger.
  • You see red streaks coming from the infected area.

Contact your healthcare provider if:

  • You have a fever.
  • Your fever or pain does not go away or gets worse.
  • The area does not get smaller after 2 days of antibiotics.
  • Your skin is flaking or peeling off.
  • You have questions or concerns about your condition or care.

Medicines:

  • Antibiotics help treat the bacterial infection.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child’s healthcare provider.
  • Acetaminophen decreases pain and fever. It is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

  • Elevate the area above the level of your heart as often as you can. This will help decrease swelling and pain. Prop the area on pillows or blankets to keep it elevated comfortably.
  • Clean the area daily until the wound scabs over. Gently wash the area with soap and water. Pat dry. Use dressings as directed.
  • Place cool or warm, wet cloths on the area as directed. Use clean cloths and clean water. Leave it on the area until the cloth is room temperature. Pat the area dry with a clean, dry cloth. The cloths may help decrease pain.

Prevent cellulitis:

  • Do not scratch bug bites or areas of injury. You increase your risk for cellulitis by scratching these areas.
  • Do not share personal items, such as towels, clothing, and razors.
  • Clean exercise equipment with germ-killing cleaner before and after you use it.
  • Wash your hands often. Use soap and water. Wash your hands after you use the bathroom, change a child’s diapers, or sneeze. Wash your hands before you prepare or eat food. Use lotion to prevent dry, cracked skin.

  • Wear pressure stockings as directed. You may be told to wear the stockings if you have peripheral edema. The stockings improve blood flow and decrease swelling.
  • Treat athlete’s foot. This can help prevent the spread of a bacterial skin infection.

Follow up with your healthcare provider within 3 days, or as directed:

Your healthcare provider will check if your cellulitis is getting better. You may need different medicine. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

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Learn more about Cellulitis (Aftercare Instructions)

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Symptoms and treatments

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Mayo Clinic Reference

  • Cellulitis

It is important that any breaks in the skin, for example due to athlete’s foot or eczema, are treated to prevent repeated episodes of cellulitis. Your doctor may prescribe topical medication (in a cream) for this. Any leg swelling after the skin infection has settled should be treated with compression stockings until the swelling has gone completely.

If there are repeated episodes of cellulitis or erysipelas, the doctor may suggest long-term preventative antibiotic treatment.

Self Care (What can I do?)

  • See your doctor as early as possible if you think you are getting another attack of erysipelas or cellulitis. If the attacks become frequent, your doctor may give you a prescription for an antibiotic to keep at home and take as soon as you notice any symptoms of infection.
  • You should follow advice about skin care to reduce breaks in the skin.
  • Support stocking, leg elevation and weight loss can help any remaining swelling of your legs.
  • Avoid smoking and stay clear from smokers when using paraffin-based products, as theses are highly flammable.

CAUTION: This leaflet mentions ‘emollients’ (moisturisers). When paraffin-containing emollient products get in contact with dressings, clothing, bed linen or hair, there is a danger that a naked flame or cigarette smoking could cause these to catch fire. To reduce the fire risk, patients using paraffin-containing skincare or haircare products are advised to avoid naked flames completely, including smoking cigarettes and being near people who are smoking or using naked flames. It is also advisable to wash clothing and bed linen regularly, preferably daily.

Where can I get more information about cellulitis and erysipelas?

http://www.dermnetnz.org/doctors/bacterial-infections/cellulitis.html (includes photographs)

http://www.dermnetnz.org/bacterial/erysipelas.html (includes photographs)

For details of source materials used please contact the Clinical Standards Unit ([email protected]).

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET
PRODUCED JANUARY 2012
UPDATED FEBRUARY 2015, MARCH 2018
REVIEW DATE MARCH 2021

Cellulitis is a type of infection that affects the skin and the tissue underneath. The bacteria, most commonly Group A streptococcal bacteria, enter the skin through an opening, such as cut, scrape, burn, or surgical incision, or even a bug bite or sting.

Cellulitis can trigger sepsis in some people. Sometimes incorrectly called blood poisoning by members of the general public, sepsis is the body’s often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and treatment for survival.

Often incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, and urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly) and/or amputations.

Where does cellulitis occur?

The infection is most common on the lower legs, but it can happen anywhere on the body. The symptoms for cellulitis include:

  • Redness around the area where the bacteria entered the skin
  • Tenderness, soreness of the affected area
  • Swelling
  • Blisters
  • Fever
  • “Dimpling” of the skin

Risk factors for cellulitis

Anyone can develop cellulitis, but some people have a higher risk than others. If you fall into one of the higher risk categories, you should watch any injuries to the skin carefully:

Impaired immune system: People who have an impaired immune system are more vulnerable to contracting infections. These include people who are undergoing chemotherapy or who take corticosteroids. Visit Sepsis and Impaired Immune System to learn more.

Chronic illnesses: Illnesses like diabetes can increase your risk of developing infections. People with diabetes are particularly susceptible to getting sores on their feet and lower legs, which can become infected. (Sepsis and Diabetes)

Skin conditions or disorders: Skin conditions and disorders can cause breaks in the skin. These include eczema, shingles, even so-called childhood illnesses like chicken pox.

Lymphedema: Lymphedema is a swelling of an arm or leg, most commonly caused by the removal of or damage to the lymph nodes as a part of cancer treatment. The swollen and stretched skin can crack.

Obesity: People who are obese have a higher risk of having cellulitis and of getting it again.

History of cellulitis: If you’ve had cellulitis before, you do have a higher risk of getting it again.

Treatment

If you suspect you have cellulitis, see your doctor or nurse practitioner. If you are given antibiotics, it is vital that you take them as prescribed, right to the end of the prescription, even if it appears the infection has gone away before the prescription bottle is empty. Ask your doctor or nurse practitioner when you should start seeing improvement. If you feel that the infection is worsening or there is no improvement despite treatment, you should have the infection checked again.

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”

The information here is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.

Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.

Updated December 13, 2017

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Cellulitis cannot always be prevented, but the risk of developing cellulitis can be minimised by avoiding injury to the skin, maintain good hygiene and by managing skin conditions like tinea and eczema.

A common cause of infection to the skin is via the fingernails. Handwashing is very important as well as keeping good care of your nails by trimming and cleaning them. Generally maintaining good hygiene such as daily showering and wearing clean clothes may help reduce the skin’s contact with bacteria.

If you have broken skin, keep the wound clean by washing daily with soap and water or antiseptic. Cover the wound with a gauze dressing or bandaid every day and watch for signs of infection.

People who are susceptible to cellulitis, for example people with diabetes or with poor circulation, should take care to protect themselves with appropriate footwear, gloves and long pants when gardening or bushwalking, when it’s easy to get scratched or bitten. Look after your skin by regularly checking your feet for signs of injury, moisturising the skin and trimming fingernails and toenails regularly.

People with swelling of the arm or leg due to a condition such as lymphoedema sometimes develop cellulitis that keeps coming back. In these cases, the first step is to work with your doctor to find the cause of the swelling and prevent the cellulitis happening. The treatment of the cellulitis remains the same for any cause. In people who have cellulitis more than two or three times, taking antibiotics for long periods (even a year or two) can help.

While cellulitis is not generally contagious, it’s important to always wash your hands before and after touching the infected area. This will reduce the chance of spreading the infection further.

Follow the links below to find trusted information about cellulitis.

Preventive treatments for repeated episodes of cellulitis and erysipelas

Background

Cellulitis and erysipelas are both bacterial infections of the skin that most commonly affect the leg. Erysipelas affects the upper layers of the skin, and cellulitis affects its deeper parts, but in practice it is often hard to tell the difference between them, so we consider them together for this review (and refer to them as ‘cellulitis’). Up to 50% of people with cellulitis experience repeated episodes. Despite the burden of this condition, there is a lack of high-certainty, evidence-based information about the desirable treatment for the prevention of recurrent cellulitis.

Review question

What are the best available treatments to prevent repeated episodes of cellulitis in adults aged over 16 years compared to no treatment, placebo, another intervention, or the same intervention with a different plan of treatment, and what are their side effects?

Study characteristics

We searched relevant databases and registers up to June 2016. We identified six trials, with 573 participants, who had an average age between 50 and 70. Both genders were included, but there were nearly twice as many women. Five trials used antibiotic treatment (four penicillin and one erythromycin), which was compared to either no treatment or placebo, and one trial used selenium compared to physiological salt solution. Treatments lasted from six to 18 months.

The most common setting was the hospital, and two studies were multicentre. The studies were conducted in the UK, Sweden, Tunisia, Israel, and Austria. There was a small number of previous episodes of cellulitis in those recruited to the trials, ranging between one and four episodes in each study. The antibiotic trials assessed prevention with antibiotics in people with cellulitis of the legs, and the selenium trial assessed people with cellulitis of the arms.

Key results

Our main outcome was prevention of repeated episodes of cellulitis. Our other outcomes included the number of repeated attacks of cellulitis, time to next attack, hospitalisation, quality of life, development of antibiotic resistance, adverse reactions and death.

Combining the results of all five trials that used antibiotics, we found moderate-certainty evidence that for those people under preventative treatment, antibiotic treatment in general, and penicillin in particular, is probably both effective and safe for the prevention of repeated episodes of leg cellulitis when compared with no treatment or placebo.

The analyses showed that, compared with no treatment or placebo, taking antibiotics decreased the risk of future episodes by 69%, reduced their number by more than 50%, and significantly reduced the rate until the next attack (moderate-certainty evidence). However, we found low-certainty evidence that the protective effect of antibiotics for these three outcomes tailed off over time after treatment had been stopped. In addition, the beneficial effect of antibiotics was relevant for people with at least two past episodes of cellulitis within a time frame of up to three years.

We found low-certainty evidence that there is no difference between antibiotics and no treatment/placebo for side effects and hospitalisation. The evidence did not allow for full exploration of the treatment’s effect on length of hospital stay.

No serious adverse effects were reported, and common side effects included diarrhoea, nausea, rash (severe skin adverse reactions were not reported) and thrush. In three studies, adverse effects caused those taking part to stop taking the antibiotic. Three people taking erythromycin had abdominal pain and nausea, causing them to stop taking the treatment and to take penicillin instead. In one study, two people withdrew from treatment with penicillin because of diarrhoea or nausea. In another study, because of pain at the site of injection, around 10% of those taking part stopped taking intramuscular injections of benzathine penicillin.

None of the included studies measured quality of life or the development of antibiotic resistance.

Certainty of evidence

Evidence for the effects of antibiotics compared with no treatment or placebo on the recurrence, incidence rate and time to next episode of cellulitis under preventive treatment was of moderate certainty, and was limited by the small number of participants and events. Evidence for the remaining reported outcomes was of low certainty for the same reasons, as well as imprecise results.

Cellulitis

What is cellulitis?

Cellulitis is bacterial infection of the skin and the tissues beneath the skin. It can occur on any part of the body.

Is cellulitis contagious?

Cellulitis is not contagious.

Who gets cellulitis?

Anyone can get cellulitis. Generally, a wound such as a cut, ulcer, animal bite, or surgical site puts a person at risk for cellulitis. Some people, however, particularly those with a weakened immune system, can get cellulitis without a cut or sore.

What causes cellulitis?

Cellulitis can be caused by many different bacteria. The most common organisms are group A streptococci and S. aureus. Cellulitis that develops in the setting of a chronic ulcer is often caused by a mix of bacterial species.

What are the symptoms of cellulitis?

A person with cellulitis often notices prominent symptoms in the affected area. These symptoms include:

  • Pain
  • Tenderness
  • Redness
  • Swelling
  • Warmth
  • Fluid-filled blisters
  • Discharge

Cellulitis can also cause fevers and chills, which may be present before the local symptoms arise.

If you notice any of these symptoms, you should see your doctor immediately.

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