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Celulite e erisipela

Last reviewed: 20 Aug 2025
Last updated: 10 Jun 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • desconforto cutâneo
  • eritema macular
  • ruptura da barreira cutânea
  • eritema vermelho-vivo elevado com margens nitidamente demarcadas (erisipela)
  • risco de infecção por Staphylococcus aureus resistente à meticilina (MRSA)
Full details

Other diagnostic factors

  • história de diabetes
  • pródromo de sintomas gerais
  • linfangite/linfadenopatia regional
  • Via de entrada identificável
  • história de imunocomprometimento
  • exposição incomum (água doce ou salgada, picada)
Full details

Risk factors

  • diabetes
  • insuficiência venosa e edema de membros inferiores crônico
  • dermatose
  • linfedema
  • episódio prévio de celulite
  • anormalidades no espaço entre os pododáctilos
  • uso de substâncias por via intravenosa
  • sobrepeso
Full details

Diagnostic investigations

1st investigations to order

  • Hemograma completo
  • cultura do foco purulento e procedimentos diagnósticos moleculares
Full details

Investigations to consider

  • aspiração de pele com cultura e procedimentos diagnósticos moleculares
  • hemocultura
  • biópsia de pele
  • radiografia simples
  • ultrassonografia
  • Tomografia computadorizada (TC)
  • RNM
Full details

Treatment algorithm

ACUTE

leve

moderado

grave

ONGOING

falha do tratamento

recidivas frequentes

Contributors

Authors

Arash Mostaghimi, MD, MPA, MPH

Assistant Professor of Dermatology

Harvard Medical School

Director, Inpatient Consultation Service

Department of Dermatology

Brigham and Women’s Hospital

Boston

MA

Disclosures

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.

Acknowledgements

Dr Arash Mostaghimi would like to gratefully acknowledge Dr Matthew C. Robinson, the previous contributor to this topic.

Disclosures

MCR declares that he has no competing interests.

Peer reviewers

Robert W. Bradsher, MD

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.

Jorg Ruhe, MD, MPH

Assistant Attending

Beth Israel Medical Center

New York

NY

利益声明

JR declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Raff AB, Kroshinsky D. Cellulitis: a review. JAMA. 2016 Jul 19;316(3):325-37. 摘要

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.全文  摘要

American College of Radiology. ACR appropriateness criteria: suspected osteomyelitis, septic arthritis, or soft tissue infection (excluding spine and diabetic foot). 2022 [internet publication].全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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