Last reviewed: 22 Dec 2020
Last updated: 18 Oct 2019
Summary
Definition
History and exam
Key diagnostic factors
- skin discomfort
- macular erythema with indistinct borders on the skin
- disruption of cutaneous barrier
- raised erythema with clearly demarcated margins (erysipelas)
- risk of infection with MRSA
Other diagnostic factors
- history of diabetes
- constitutional prodrome
- lymphangitis/regional lymphadenopathy
- history of immunocompromise
- unusual exposure (salt or fresh water, bite)
Risk factors
- prior episode of cellulitis
- ulcer/wound
- dermatosis
- tinea pedis interdigitalis
- lymphedema
- venous insufficiency/chronic leg edema
- overweight
Diagnostic investigations
1st investigations to order
- CBC
- purulent focus culture and molecular diagnostic procedures
Investigations to consider
- interdigital space culture
- skin aspiration with culture and molecular diagnostic procedures
- blood culture
- skin biopsy
- plain film x-ray
- ultrasound
- CT scan
- MRI
Treatment algorithm
Contributors
Authors
Infectious Disease Physician
Austin Infectious Disease Consultants
Austin
TX
Disclosures
MCR declares that he has no competing interests.
Peer reviewers
Ebert Professor of Medicine
Director
Division of Infectious Diseases
University of Arkansas for Medical Sciences
Little Rock
AR
Disclosures
RWB declares that he has no competing interests.
Assistant Attending
Beth Israel Medical Center
New York
NY
Disclosures
JR declares that he has no competing interests.
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