Skin Ailments—Cellulitis
Cellulitis
General—an acute infection of the dermis and subcutaneous tissue marked by inflammation
Clinical—pain, warmth, edema, and poorly demarcated erythema on a portion of skin
A fever and elevated white blood cell (WBC) count may be present.
Etiology—typically caused by Streptococci species or Staphylococcus aureus
Blood culture is not indicated in routine cases, but warranted when patients have:
Risk factors—skin trauma, “skin popping,” underlying ulcer/fissure, edema, liposuction, and so on
Psychiatric correlate—infection in unusual areas of the body may be a clue to intravenous drug use.
Beware of endocarditis in intravenous drug users who present with cellulitis.
Imaging—not needed unless concerned about subjacent osteomyelitis, necrotizing fasciitis, and so on
Treatment
Antimicrobial treatment
Typical cellulitis (duration of treatment is usually 7-14 days)
Initial parenteral options: (for worsening disease, compromised host, or fever)
Subsequent options: (switch as cellulitis improves; often after ˜4 days)
