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Cellulitis

Karl T. Clebak, MD, FAAFP, Jarrett Keller Sell, MD, AAHIVS and Lynn K. Weaver, MD Reviewed 06/2020
 


BASICS

Infection of the skin is 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 subcutaneou...

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 JEet al. Increasing incidence, cost, and sea...

ADDITIONAL READING

  • Brindle R, Williams OM, Barton Eet al. Assessment of antibiotic treatment of cellulitis and erysipelas: a systematic review and meta-analysis. JAMA Dermatol.  2019 Jun 12. [Epu...

CODES

ICD10

  • L03.032 Cellulitis of left toe

  • L03.312 Cellulitis of back [any part except buttock]

  • L03.211 Cellulitis of face

  • L03.112 Cellulitis of left axilla

  • L03.11 Cellulitis of other parts of limb

  • L03.315 ...

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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