Cellulitis resident survival guide: Difference between revisions
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==Treatment== | ==Treatment== | ||
Shown below is an algorithm summarizing the treatment of [[cellulitis]] | Shown below is an algorithm summarizing the treatment of [[cellulitis]].<ref name="pmid17243049">{{cite journal| author=Miller LG, Quan C, Shay A, Mostafaie K, Bharadwa K, Tan N | display-authors=etal| title=A prospective investigation of outcomes after hospital discharge for endemic, community-acquired methicillin-resistant and -susceptible Staphylococcus aureus skin infection. | journal=Clin Infect Dis | year= 2007 | volume= 44 | issue= 4 | pages= 483-92 | pmid=17243049 | doi=10.1086/511041 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17243049 }} </ref> | ||
{{familytree/start |summary=PE diagnosis Algorithm.}} | {{familytree/start |summary=PE diagnosis Algorithm.}} | ||
{{familytree | | | | | | | | A01 |A01= Is the cellulitis having a purulent discharge? }} | {{familytree | | | | | | | | A01 |A01= Is the cellulitis having a purulent discharge? }} |
Revision as of 10:17, 20 October 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mydah Sajid, MD[2]
Synonyms and keywords:
Overview
Causes
Life Threatening Causes
No known life-threatening causes are included.
Common Causes
The cellulitis is bacterial in origin caused by invasion of bacteria through the skin barrier. The common causes are:
- Streptococcus pyogenes
- Staphylococcus aureus
- Haemophilus influenza type B
- Clostridium
- Streptococcus pneumoniae
- Neisseria meningitidis
Diagnosis
Shown below is an algorithm summarizing the diagnosis of cellulitis according to the Infectious Diseases Society of America guidelines.
Patients presents with clinical symptoms suggestive of cellulitis, i.e.
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Perform compression Doppler ultrasound of the limb and D-dimers level | |||||||||||||||||
Positive | Negative | ||||||||||||||||
likely Deep venous thrombosis (DVT) | DVT unlikely. High clinical suspicion for cellulitis | ||||||||||||||||
Assess levels of inflammatory markers | |||||||||||||||||
Raised ESR, CRP and leukocytosis | |||||||||||||||||
Does patient have any signs of rapidly progressive or systemic infection?
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Perform the following tests:
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Treatment
Shown below is an algorithm summarizing the treatment of cellulitis.[1]
Is the cellulitis having a purulent discharge? | |||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||
Are there any of the following clinical signs?
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Yes | No |
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Initiate intravenous antibiotic therapy. The coverage of the micro-organisms is determined by:
| Initiate oral antibiotic therapy. The coverage of the micro-organisms is determined by:
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Yes | No | Yes | No | ||||||||||||||||||||||||||||||||||
Initiate antibiotics that cover both MRSA and gram negative rods. To cover MRSA:
Plus one of the following to cover for gram negative rods
| Infection most likely due to MRSA. Initiate
| * Incision and drainage of discrete abscesses
| Assess patient's risk for infective endocarditis | ||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||
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Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ Miller LG, Quan C, Shay A, Mostafaie K, Bharadwa K, Tan N; et al. (2007). "A prospective investigation of outcomes after hospital discharge for endemic, community-acquired methicillin-resistant and -susceptible Staphylococcus aureus skin infection". Clin Infect Dis. 44 (4): 483–92. doi:10.1086/511041. PMID 17243049.