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Cellulitis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Acute, spreading erythematous superficial infection of skin and SC tissues:

    • Variety of pathogens

    • Extension into deeper tissues can result in necrotizing soft tissue infection

  • Progressiv...

Diagnosis

Signs and Symptoms

  • Common to all syndromes:

    • Pain, tenderness, warmth

    • Erythema

    • Edema or induration

    • Fever/chills

    • Tender regional lymphadenopathy

    • Lymphangitis

    • Accompanying SC abscess possible

    • Suspect de...

Treatment

Initial Stabilization/Therapy

Airway compromise possible with deep extension of facial or neck cellulitis 

Ed Treatment/Procedures

  • General principles:

    • Consider local prevalence of resistant path...

Follow-Up

Disposition

Admission Criteria

  • Toxic appearing

  • Tissue necrosis

  • History of immune suppression

  • Concurrent chronic medical illnesses

  • Unable to take oral medications

  • Unreliable patients

Discharge Criteria

Pearls and Pitfalls

  • Strep and staph are most common causes

  • CA-MRSA now significant cause of cellulitis, frequent enough to warrant including coverage in empiric treatment

  • Clinicians not accurate at iden...

Additional Reading

  • Abrahamian  FM, Talan  DA, Moran  GJ. Management of skin and soft-tissue infections in the emergency department. Infect Dis Clin North Am.  2008;22:89–116.

  • Gunderson  CG. Cellul...

Codes

ICD9

  • 682.3 Cellulitis and abscess of upper arm and forearm

  • 682.6 Cellulitis and abscess of leg, except foot

  • 682.9 Cellulitis and abscess of unspecified sites

  • 682.0 Cellulitis and abscess of face

  • 682....

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