Emergency Department Management of Cellulitis and Other Skin and Soft-Tissue Infections

Points & Pearls Excerpt

• With some 2 million cases of SSTIs presenting to EDs annually, their misdiagnosis and mismanagement leads to hundreds of millions of dollars of avoidable healthcare spending and increased risk for morbidity and mortality.
• SSTIs can be distinguished by their location in the soft tissue: erysipelas is superficial; cellulitis is in the dermal layers; and necrotizing infection is in the deeper dermal and fascial layers. (See Figure 1.)
• Purulent cellulitis is predisposed for Staphylococcus species; the IDSA recommends empiric coverage for MRSA for these patients.
• Nonpurulent cellulitis has a predominance toward infection with Streptococcus species.