Cellulitis and erysipelas
Resumen
Definição
História e exame físico
Principais fatores diagnósticos
- skin discomfort
- macular erythema
- disruption of cutaneous barrier
- raised bright-red erythema with clearly demarcated margins (erysipelas)
- risk of infection with MRSA
Outros fatores diagnósticos
- history of diabetes
- constitutional prodrome
- lymphangitis/regional lymphadenopathy
- identifiable port of entry
- history of immunocompromise
- unusual exposure (salt or fresh water, bite)
Fatores de risco
- diabetes
- venous insufficiency and chronic leg edema
- dermatosis
- lymphedema
- prior episode of cellulitis
- toe web abnormalities
- intravenous drug use
- overweight
- military service
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC
- purulent focus culture and molecular diagnostic procedures
Investigações a serem consideradas
- skin aspiration with culture and molecular diagnostic procedures
- blood cultures
- skin biopsy
- plain film x-ray
- ultrasound
- CT scan
- MRI
Algoritmo de tratamento
mild
moderate
severe
treatment failure
frequent relapses
Colaboradores
Consultores especialistas
Arash Mostaghimi, MD, MPA, MPH
Associate Professor of Dermatology
Harvard Medical School
Vice Chair, Clinical Trials and Innovation
Director, Inpatient Consultation Service
Department of Dermatology
Brigham and Women’s Hospital
Boston
MA
Declarações
AM has received fees or honoraria for consulting from hims and hers, AbbVie, Sun Pharma, Pfizer, Digital Diagnostics, Lilly, Equillium, ASLAN, Boehringer Ingelheim, Figure 1, Dermatheory, Olaplex, and Legacy Healthcare.
Agradecimentos
Dr Arash Mostaghimi would like to gratefully acknowledge Dr Matthew C. Robinson, the previous contributor to this topic.
Declarações
MCR declares that he has no competing interests.
Revisores
Robert W. Bradsher, MD
Ebert Professor of Medicine
Director
Division of Infectious Diseases
University of Arkansas for Medical Sciences
Little Rock
AR
Declarações
RWB declares that he has no competing interests.
Jorg Ruhe, MD, MPH
Assistant Attending
Beth Israel Medical Center
New York
NY
Declarações
JR declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Raff AB, Kroshinsky D. Cellulitis: a review. JAMA. 2016 Jul 19;316(3):325-37. Resumo
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.Texto completo Resumo
American College of Radiology. ACR appropriateness criteria: suspected osteomyelitis, septic arthritis, or soft tissue infection (excluding spine and diabetic foot). 2022 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Necrotizing fasciitis
- Thrombophlebitis, superficial
- Deep vein thrombosis
Mais Diagnósticos diferenciaisDiretrizes
- 2018 WSES/SIS-E consensus conference: recommendations for the management of skin and soft-tissue infections
- Practice guidelines for the diagnosis and management of skin and soft tissue infections
Mais DiretrizesVideos
Venepuncture and phlebotomy: animated demonstration
Peripheral intravascular catheter: animated demonstration
Mais vídeosFolhetos informativos para os pacientes
Cellulitis and erysipelas
Mais Folhetos informativos para os pacientes
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