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

Show Notes

• Why cellulitis/skin infections?  
• Terminology
  • Erysipelas vs cellulitis vs fasciitis  
  • Purulent cellulitis 
• Most common pathogens 
• Special situations  
• Necrotizing infection classification system – is this helpful in the ED, and if so, why? 
• Differential – unilateral vs bilateral presentation 
• Prehospital care  
• ED evaluation
  • History – what should we be asking? 
  • Examination: SSTI vs NSTI 
• Diagnostics
  • POCUS: “cobblestoning” and fluid collection 
  • X-ray: subcutaneous gas 
  • CT: when is this helpful? 
• Labs
  • Blood cultures – if given the option, are they helpful? 
  • Wound cultures – any role for these?  
  • Routine labs (CBC, BMP, etc) – are they helpful? 
  • LRINEC score – what is it and should we be using it? 
• Treatment 
  • NSTI antibiotics 
  • Abscesses 
• Special populations
  • IV drug users 
  • Diabetic patients 
  • Immunocompromised patients 
• Wound irrigation and loop drainage 
• Disposition