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Cellulitis

Lynn Weaver, MD, Karl T. Clebak, MD, FAAFP and Jarrett Sell, MD, AAHIVS Reviewed 06/2019
 


BASICS

A common global health burden with >650,000 admissions per year in the United States alone (1

DESCRIPTION

  • An acute bacterial infection of the dermis and subcutaneous (SC) tissue

  • Types and loc...

DIAGNOSIS

Primarily a clinical diagnosis 

HISTORY

  • Previous trauma, surgery, animal/human bites, dermatitis, and fungal infection are portals of entry for bacterial pathogens.

  • Pain, itching, and/or burnin...

TREATMENT

GENERAL MEASURES

  • Immobilize/elevate involved limb to reduce swelling.

  • Sterile saline dressings or cool aluminum acetate compresses for pain relief

  • Edema: compression stocking, pneumatic pumps; ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Repeat relevant labs (blood culture, CBC, potentially lumbar puncture) if patient is toxic or not improving.

  • Cutaneous inflammation may worsen in...

REFERENCES

1
Raff A, Kroshinsky D. Cellulitis: a review. JAMA.  2016;316(3):325–337. [View Abstract on OvidMedline]
2
Peterson RA, Polgreen LA, Cavanaugh JE, et al. Increasing incidence, cost, and s...

ADDITIONAL READING

  • Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infec...

CODES

ICD10

  • L03.90 Cellulitis, unspecified

  • H05.019 Cellulitis of unspecified orbit

  • L03.211 Cellulitis of face

  • J36 Peritonsillar abscess

  • H05.012 Cellulitis of left orbit

  • H05.013 Cellulitis of bilateral orbit...

CLINICAL PEARLS

  • S. aureus and group A Streptococcus are the most common organisms causing cellulitis.

  • Consider MRSA if cellulitis does not respond to antibiotics within 48 hours or if purulence present...

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