Hand cellulitis: Difference between revisions
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==Background== | ==Background== | ||
[[File:Wrist and hand deeper palmar dissection.svg|thumb|Wrist and hand deeper palmar dissection]] | |||
*Remove rings if infections are near the digits | *Remove rings if infections are near the digits | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC4131574 eplasty14ic25 fig1.png|thumb|Hand cellulitis (from [[cat bite]]).]] | |||
[[File:PMC4131574 eplasty14ic25 fig2.png|thumb|Hand cellulitis (from [[cat bite]]).]] | |||
[[File:PMC4131574 eplasty14ic25 fig3.png|thumb|Lymphadenitis extending from hand cellulitis.]] | |||
*Erythema, warmth, and edema | *Erythema, warmth, and edema | ||
*Range of motion of digits, hand, and wrist should not be painful | *Range of motion of digits, hand, and wrist should not be painful | ||
**Pain predicts extensive involvement and the need for inpatient management | **Pain predicts extensive involvement and the need for inpatient management | ||
== | ==Differential Diagnosis== | ||
{{Template:Hand Infection DDX}} | {{Template:Hand Infection DDX}} | ||
== | ==Evaluation== | ||
*Usually clinical | |||
*Consider films and [[ultrasound]] to evaluate for [[osteomyelitis]], [[abscess]], or [[necrotizing cellulitis]] | |||
==Management== | |||
*Mild/moderate cellulitis | *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) | **[[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 | *Severe cellulitis | ||
**[[Vancomycin]] 1gm IV q12hr | **[[Vancomycin]] 1gm IV q12hr | ||
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==See Also== | ==See Also== | ||
*[[Hand | *[[Hand and finger infections]] | ||
*[[Cellulitis]] | *[[Cellulitis]] | ||
== | ==References== | ||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 21:47, 12 August 2020
Background
- Remove rings if infections are near the digits
Clinical Features
Hand cellulitis (from cat bite).
Hand cellulitis (from cat bite).
- 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 films 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