Patients with a history of cellulitis, particularly of the lower limbs, have an estimated recurrence rate of 8–20%.12 Patients with recurrent cellulitis should be carefully evaluated for any predisposing factors such as lower limb edema, lymphoedema, dermatitis, tinea pedis, and measures taken to address them. Patients with three to four episodes of cellulitis per year despite addressing predisposing factors could be considered for prophylactic antimicrobial therapy so long as those factors persist. A randomised controlled trial of phenoxymethylpenicillin prophylaxis in patients with a history of recurrent cellulitis showed a reduced rate of recurrence in the treatment group with a hazard ratio of 0.55

The recurrence is due to dozens or hundreds of encapsulated strep or staff that can leak into the surrounding tissue. When those pockets progress deep into the body it can be life-threatening. This reminds me of King Henry the 8th and a usual suspect.