Cellulitis - Revision history

Aidan at 17:46, 14 July 2022

2022-07-14T17:46:15Z

← Older revision		Revision as of 17:46, 14 July 2022
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	***Shellfish, meats, hides		***Shellfish, meats, hides
	***IV drug use		***IV drug use
	***Animal or human bites		***[[Animal bites\|Animal or human bites]]
	**Poor adherence/absorption/distribution		**Poor adherence/absorption/distribution
	**Wrong diagnosis		**Wrong diagnosis
	**Impatience!		**Impatience!
	*Complications of infection		*Complications of infection
	**Abscess (drain it)		**[[Abscess]] (drain it)
	**Deep infection		**Deep infection
	**Metastasis		**Metastasis
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	*May be indicated for patients with recurrent cellulitis		*May be indicated for patients with recurrent cellulitis
	*Penicillin V 250 mg po bid		*[[Penicillin V]] 250 mg po bid
	*Read more: Oh CC ''et al''. [https://doi.org/10.1016/j.jinf.2014.02.011 Antibiotic prophylaxis for preventing recurrent cellulitis: A systematic review and meta-analysis]. ''J Infect''. 2014;69(1):26-34.		*Read more: Oh CC ''et al''. [https://doi.org/10.1016/j.jinf.2014.02.011 Antibiotic prophylaxis for preventing recurrent cellulitis: A systematic review and meta-analysis]. ''J Infect''. 2014;69(1):26-34.

Aidan: /* Management */

2021-03-28T18:02:41Z

Management

← Older revision		Revision as of 18:02, 28 March 2021
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			== Background ==

	*Infection of superficial skin and skin structures		*Infection of superficial skin and skin structures

	==~~Etiology~~==		===Microbiology===

	*''[[Streptococcus pyogenes]]'' (much more common)		*''[[Streptococcus pyogenes]]'' (much more common)
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	**Butchers: ''[[Erysipelothrix]]'' (erysipeloid)		**Butchers: ''[[Erysipelothrix]]'' (erysipeloid)

		⚫	==Clinical Manifestations==
⚫	==Differential Diagnosis==

		⚫	*Hot, red, swollen, tender area of skin with poorly demarcated margins
		⚫	*With or without pus and/or bullae
		⚫	*Legs more common than elsewhere

			== Diagnosis ==

			* Clinical based on typical appearance

		⚫	== Differential Diagnosis ==

	*Skin and soft tissue infections		*Skin and soft tissue infections
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	**[[Acute inflammatory edema]]		**[[Acute inflammatory edema]]
	*For an exhaustive list, see [[Cellulitis mimickers]]		*For an exhaustive list, see [[Cellulitis mimickers]]

⚫	==Clinical Manifestations==

⚫	*Hot, red, swollen, tender area of skin with poorly demarcated margins
⚫	*With or without pus and/or bullae
⚫	*Legs more common than elsewhere

	==Management==		==Management==
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	*Source control: drain any abscess		*Source control: drain any abscess
	*Antibiotics for 5-7 days		*Antibiotics for 5-7 days
	*Purulent SSTI		**Purulent SSTI
	**Cephalexin or cefazolin are good first-line empiric choices		***[[Cephalexin]] or [[cefazolin]] are good first-line empiric choices
	**Doxycycline or vancomycin can also be considered		***Doxycycline or vancomycin can also be considered
	*Non-purulent SSTI		**Non-purulent SSTI
	**Cephalexin ~~500mg~~ po qid or cefazolin 1-2g IV q8h for 5-7 days		***[[Cephalexin]] 500 mg po qid or [[cefazolin]] 1-2 g IV q8h for 5-7 days
	**If penicillin allergy		***If penicillin allergy
	***~~Clindamycin300mg~~ po qid		****[[Clindamycin]] 300 mg po qid
	***Moxifloxacin ~~400mg~~ po daily		****[[Moxifloxacin]] 400 mg po daily
	***Linezolid ~~600mg~~ po bid		****[[Linezolid]] 600 mg po bid
	***Clindamycin ~~600mg~~ IV tid		****[[Clindamycin]] 600 mg IV tid
	***Vancomycin 1g IV q12h		****[[Vancomycin]] 1 g IV q12h
	*Non-resolving cellulitis		*Non-resolving cellulitis
	**Bug-drug mismatch		**Bug-drug mismatch

Aidan: /* Differential Diagnosis */

2021-03-24T23:00:02Z

Differential Diagnosis

← Older revision		Revision as of 23:00, 24 March 2021
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	* Infection of superficial skin and skin structures		*Infection of superficial skin and skin structures

	== Etiology ==		==Etiology==

	* ''[[Streptococcus pyogenes]]'' (much more common)		*''[[Streptococcus pyogenes]]'' (much more common)
	* ''[[Staphylococcus aureus]]'' (especially if purulent)		*''[[Staphylococcus aureus]]'' (especially if purulent)
	* Rare, depending on exposures:		*Rare, depending on exposures:
	** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''		**Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''
	** Facial cellulitis in children: ''[[Haemophilus influenzae]]''		**Facial cellulitis in children: ''[[Haemophilus influenzae]]''
	** Human bite wounds: [[anaerobes]], ''[[Eikenella]]'', [[Viridans group streptococci]]		**Human bite wounds: [[anaerobes]], ''[[Eikenella]]'', [[Viridans group streptococci]]
	** Cat or dog bites: ''[[Pasteurella multocida]]''		**Cat or dog bites: ''[[Pasteurella multocida]]''
	** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)		**Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)
	** Fresh- or saltwater exposure: ''[[Aeromonas hydrophila]]'' (e.g. leech bites)		**Fresh- or saltwater exposure: ''[[Aeromonas hydrophila]]'' (e.g. leech bites)
	** Butchers: ''[[Erysipelothrix]]'' (erysipeloid)		**Butchers: ''[[Erysipelothrix]]'' (erysipeloid)

	== Differential Diagnosis ==		==Differential Diagnosis==

	* Skin and soft tissue infections		*Skin and soft tissue infections
	** Cellulitis (Strep >> Staph)		**Cellulitis (Strep >> Staph)
	** [[Erysipelas]] (usually Strep)		**[[Erysipelas]] (usually Strep)
	** [[Abscess]] (usually Staph)		**[[Abscess]] (usually Staph)
	** Folliculitis (usually Staph or Pseudomonas): warm compresses and mupirocin ointment		**Folliculitis (usually Staph or Pseudomonas): warm compresses and mupirocin ointment
	** [[Impetigo]] (usually Staph): watchful waiting, or topical or systemic antibiotics		**[[Impetigo]] (usually Staph): watchful waiting, or topical or systemic antibiotics
	** Carbuncles		**Carbuncles
	** [[Necrotizing fasciitis]]		**[[Necrotizing fasciitis]]
	* Other disease		*Other disease
	** Deep vein thrombosis		**[[Deep vein thrombosis]]
	** Gout (if over a joint)		**[[Gout]] (if over a joint)
	** Erythema nodosum		**[[Erythema nodosum]]
			**[[Acute inflammatory edema]]
	* For an exhaustive list, see [[Cellulitis mimickers]]		*For an exhaustive list, see [[Cellulitis mimickers]]

	== Clinical Manifestations ==		==Clinical Manifestations==

	* Hot, red, swollen, tender area of skin with poorly demarcated margins		*Hot, red, swollen, tender area of skin with poorly demarcated margins
	* With or without pus and/or bullae		*With or without pus and/or bullae
	* Legs more common than elsewhere		*Legs more common than elsewhere

	== Management ==		==Management==

	* Source control: drain any abscess		*Source control: drain any abscess
	* Antibiotics for 5-7 days		*Antibiotics for 5-7 days
	* Purulent SSTI		*Purulent SSTI
	** Cephalexin or cefazolin are good first-line empiric choices		**Cephalexin or cefazolin are good first-line empiric choices
	** Doxycycline or vancomycin can also be considered		**Doxycycline or vancomycin can also be considered
	* Non-purulent SSTI		*Non-purulent SSTI
	** Cephalexin 500mg po qid or cefazolin 1-2g IV q8h for 5-7 days		**Cephalexin 500mg po qid or cefazolin 1-2g IV q8h for 5-7 days
	** If penicillin allergy		**If penicillin allergy
	*** Clindamycin300mg po qid		***Clindamycin300mg po qid
	*** Moxifloxacin 400mg po daily		***Moxifloxacin 400mg po daily
	*** Linezolid 600mg po bid		***Linezolid 600mg po bid
	*** Clindamycin 600mg IV tid		***Clindamycin 600mg IV tid
	*** Vancomycin 1g IV q12h		***Vancomycin 1g IV q12h
	* Non-resolving cellulitis		*Non-resolving cellulitis
	** Bug-drug mismatch		**Bug-drug mismatch
	** Resistance		**Resistance
	** Poor antibiotic choice		**Poor antibiotic choice
	** Unusual organism		**Unusual organism
	*** Water exposure (fresh- or saltwater)		***Water exposure (fresh- or saltwater)
	*** Fish		***Fish
	*** Shellfish, meats, hides		***Shellfish, meats, hides
	*** IV drug use		***IV drug use
	*** Animal or human bites		***Animal or human bites
	** Poor adherence/absorption/distribution		**Poor adherence/absorption/distribution
	** Wrong diagnosis		**Wrong diagnosis
	** Impatience!		**Impatience!
	* Complications of infection		*Complications of infection
	** Abscess (drain it)		**Abscess (drain it)
	** Deep infection		**Deep infection
	** Metastasis		**Metastasis

	=== Prophylaxis ===		===Prophylaxis===

	* May be indicated for patients with recurrent cellulitis		*May be indicated for patients with recurrent cellulitis
	* Penicillin V 250 mg po bid		*Penicillin V 250 mg po bid
	* Read more: Oh CC ''et al''. [https://doi.org/10.1016/j.jinf.2014.02.011 Antibiotic prophylaxis for preventing recurrent cellulitis: A systematic review and meta-analysis]. ''J Infect''. 2014;69(1):26-34.		*Read more: Oh CC ''et al''. [https://doi.org/10.1016/j.jinf.2014.02.011 Antibiotic prophylaxis for preventing recurrent cellulitis: A systematic review and meta-analysis]. ''J Infect''. 2014;69(1):26-34.

	[[Category:Skin and soft tissue infections]]		[[Category:Skin and soft tissue infections]]

Aidan: Text replacement - "== Presentation" to "== Clinical Manifestations"

2020-08-02T13:10:32Z

Text replacement - "== Presentation" to "== Clinical Manifestations"

← Older revision		Revision as of 13:10, 2 August 2020
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	* For an exhaustive list, see [[Cellulitis mimickers]]		* For an exhaustive list, see [[Cellulitis mimickers]]

	== ~~Presentation~~ ==		== Clinical Manifestations ==

	* Hot, red, swollen, tender area of skin with poorly demarcated margins		* Hot, red, swollen, tender area of skin with poorly demarcated margins

Aidan: Text replacement - "Viridans group Streptococci" to "Viridans group streptococci"

2020-02-15T00:42:29Z

Text replacement - "Viridans group Streptococci" to "Viridans group streptococci"

← Older revision		Revision as of 00:42, 15 February 2020
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	** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''		** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''
	** Facial cellulitis in children: ''[[Haemophilus influenzae]]''		** Facial cellulitis in children: ''[[Haemophilus influenzae]]''
	** Human bite wounds: [[anaerobes]], ''[[Eikenella]]'', [[Viridans group ~~Streptococci~~]]		** Human bite wounds: [[anaerobes]], ''[[Eikenella]]'', [[Viridans group streptococci]]
	** Cat or dog bites: ''[[Pasteurella multocida]]''		** Cat or dog bites: ''[[Pasteurella multocida]]''
	** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)		** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)

Aidan: /* Differential Diagnosis */

2019-08-19T23:25:32Z

Differential Diagnosis

← Older revision		Revision as of 23:25, 19 August 2019
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	* Skin and soft tissue infections		* Skin and soft tissue infections
	** Cellulitis (Strep/Staph)		** Cellulitis (Strep >> Staph)
	** [[Erysipelas]] (usually Strep)		** [[Erysipelas]] (usually Strep)
	** [[Abscess]] (usually Staph)		** [[Abscess]] (usually Staph)

Aidan: /* Etiology */

2019-08-19T23:25:10Z

Etiology

← Older revision		Revision as of 23:25, 19 August 2019
Line 8:		Line 8:
	** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''		** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''
	** Facial cellulitis in children: ''[[Haemophilus influenzae]]''		** Facial cellulitis in children: ''[[Haemophilus influenzae]]''
	** Human bite wounds: ~~Anaerobes~~, ''[[Eikenella]]'', [[Viridans group Streptococci]]		** Human bite wounds: [[anaerobes]], ''[[Eikenella]]'', [[Viridans group Streptococci]]
	** Cat or dog bites: ''[[Pasteurella multocida]]''		** Cat or dog bites: ''[[Pasteurella multocida]]''
	** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)		** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)

Aidan: /* Etiology */

2019-08-19T23:24:51Z

Etiology

← Older revision		Revision as of 23:24, 19 August 2019
Line 8:		Line 8:
	** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''		** Hand or foot puncture: ''[[Pseudomonas aeruginosa]]''
	** Facial cellulitis in children: ''[[Haemophilus influenzae]]''		** Facial cellulitis in children: ''[[Haemophilus influenzae]]''
	** Human bite wounds: Anaerobes, ''[[Eikenella]]'', [[~~viridans-~~group Streptococci]]		** Human bite wounds: Anaerobes, ''[[Eikenella]]'', [[Viridans group Streptococci]]
	** Cat or dog bites: ''[[Pasteurella multocida]]''		** Cat or dog bites: ''[[Pasteurella multocida]]''
	** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)		** Saltwater exposure: ''[[Vibrio vulnificus]]'' (e.g. injury on coral)

Aidan at 19:31, 15 August 2019

2019-08-15T19:31:15Z

← Older revision		Revision as of 19:31, 15 August 2019
Line 1:		Line 1:
	* Infection of superficial skin and skin structures		* Infection of superficial skin and skin structures

	= Etiology =		== Etiology ==

	* ''[[Streptococcus pyogenes]]'' (much more common)		* ''[[Streptococcus pyogenes]]'' (much more common)
Line 14:		Line 14:
	** Butchers: ''[[Erysipelothrix]]'' (erysipeloid)		** Butchers: ''[[Erysipelothrix]]'' (erysipeloid)

	= Differential Diagnosis =		== Differential Diagnosis ==

	* Skin and soft tissue infections		* Skin and soft tissue infections
Line 30:		Line 30:
	* For an exhaustive list, see [[Cellulitis mimickers]]		* For an exhaustive list, see [[Cellulitis mimickers]]

	= Presentation =		== Presentation ==

	* Hot, red, swollen, tender area of skin with poorly demarcated margins		* Hot, red, swollen, tender area of skin with poorly demarcated margins
Line 36:		Line 36:
	* Legs more common than elsewhere		* Legs more common than elsewhere

	= Management =		== Management ==

	* Source control: drain any abscess		* Source control: drain any abscess
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	** Metastasis		** Metastasis

	== Prophylaxis ==		=== Prophylaxis ===

	* May be indicated for patients with recurrent cellulitis		* May be indicated for patients with recurrent cellulitis

Aidan: /* Differential Diagnosis */

2019-08-15T03:53:24Z

Differential Diagnosis

← Older revision		Revision as of 03:53, 15 August 2019
Line 28:		Line 28:
	** Gout (if over a joint)		** Gout (if over a joint)
	** Erythema nodosum		** Erythema nodosum
	* For an exhaustive list, see [[Cellulitis mimickers](]		* For an exhaustive list, see [[Cellulitis mimickers]]

	= Presentation =		= Presentation =