Cellulitis

Background

• Acute non-purulent spreading infection of the subcutanous tissue, causing overlying skin inflammation
• Most often caused by strep, staph, MRSA
• H.flu is most common cause in the orbit.

DDx

Skin and Soft Tissue Infection

• Cellulitis
  • Hand cellulitis
  • Facial cellulitis
  • Orbital cellulitis
• Erysipelas
• Lymphangitis
• Folliculitis
• Hidradenitis suppurativa
• Skin abscess
  • Anorectal abscess
  • Bartholin gland abscess
  • Pilonidal abscess
  • Scrotal abscess
• Necrotizing soft tissue infections
  • Necrotizing fasciitis
  • Necrotizing myositis
  • Necrotizing cellulitis
  • Fournier's gangrene
• Mycobacterium marinum

Look-A-Likes

• Sporotrichosis
• Osteomyelitis
• Deep venous thrombosis
• Pyomyositis
• Purple glove syndrome
• Tuberculosis (tuberculous inflammation of the skin)

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

• Digital mixoid cyst

Diagnosis

• Often accompanied by fever, chills, malaise, HA, vomiting
• Rash
  • Local redness, heat, swelling
  • Warm tender indistinct margins. Pyrexia may signify systemic spread

Treatment

• For MRSA
  • Vancomycin, Clindamycin or TMP-SMZ plus a Beta Lactam.
• Mild cases or following initial parenteral therapy
  • Dicloxacillin or cephalexin

See Also

• Hand Cellulitis

Source

• Tintinalli