Cellulitis and other skin and soft-tissue infections (SSTIs) are common presentations in the emergency department. This review describes the varied etiologies and patient presentations of the more common SSTIs: cellulitis, abscesses, and necrotizing soft-tissue infections. A discussion of the common diagnoses masquerading as SSTIs is presented, as well as a stepwise approach to avoiding misdiagnosis. Diagnostic studies are also evaluated, including discussions on ultrasound, computed tomography, and clinical decision rules. This review also provides an evidence-based analysis of the controversies in management of abscesses, including the commonly utilized techniques of incision and drainage, irrigation, packing, and concurrent antibiotic therapy.
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Keywords: cellulitis, abscess, necrotizing, erysipelas, purulent, MRSA, saltwater, dermatitis, gout, cobblestoning, POCUS, LRINEC, antibiotics, loop, drainage
Kyle Howarth, MD; Joby Thoppil, MD, PhD; Gilberto A. Salazar, MD, FACEP, DABEMS
Marc Kanter, MD; Jennifer White, MD
May 1, 2022
June 1, 2025
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME credits and 1 Pharmacology CME credit.