Hand cellulitis: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
*Usually clinical | *Usually clinical | ||
*Consider [[x-rays]] and [[ultrasound]] to evaluate for [[osteomyelitis]], [[abscess]], or [[necrotizing cellulitis]] | |||
==Management== | ==Management== | ||
Revision as of 16:12, 4 August 2020
Background
- Remove rings if infections are near the digits
Clinical Features
- Erythema, warmth, and edema
- Range of motion of digits, hand, and wrist should not be painful
- Pain predicts extensive involvement and the need for inpatient management
Differential Diagnosis
Hand and finger infections
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Look-Alikes
Evaluation
- Usually clinical
- Consider x-rays and ultrasound to evaluate for osteomyelitis, abscess, or necrotizing cellulitis
Management
- Mild/moderate cellulitis
- TMP-SMX DS 1-2 tab PO x 7-10d + (cephalexin 500mg PO QID x7-10d OR dicloxacillin 500mg PO QID x 7–10d)
- Severe cellulitis
- Vancomycin 1gm IV q12hr
Disposition
- Consider admission for:
- Immunocompromised
- Clinical toxicity
- Evidence of deep-space involvement
- Rapidly spreading infections