Cellulitis

Acute management of cellulitis: A review

Cellulitis is an acute localised skin infection, usually accompanied by symptoms such as fever and rigors, nausea, and vomiting. It most commonly affects the lower limbs, although it can involve any part of the skin. It presents as area of redness and inflammation of the skin, with associated pain and swelling.

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An overview of lower limb cellulitis in an acute medical ward-a few lessons we can learn

Lower limb cellulitis is a common cause for hospital admissions. In this retrospective study, we assessed the characteristics and outcome of patients admitted in an acute medical unit. The mean duration of treatment was 10.48 days, with 95.5% receiving antibiotics for more than 5 days. Mean length of stay (LOS) was 5.19 days. 12-month readmission rate was higher in patients with diabetes, chronic kidney disease (CKD) and previous stroke. Diabetes, CKD, previous stroke, and elevated procalcitonin levels were independently associated with prolonged admission (>3 days).

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An unusual pathogen in ambulatory care: two cases of Scedosporium soft tissue infections presenting as “unresponsive cellulitis”

Soft tissue infections with Scedosporium spp. are an uncommon but serious and emerging cause of infection in immunocompromised patients. Acute Medical Units (AMUs) in the UK are increasingly managing patients with cellulitis in an outpatient setting, therefore acute physicians should be aware of some of the more uncommon causes of soft tissue infection, particularly in patients not responding to initial antibiotic therapy. We present two cases of Scedosporium presenting to the AMU as cellulitis not responding to initial antibiotic therapy and outline the assessment and management of this important condition.

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Principles and Practice of Antibiotic Therapy for Cellulitis

Abstract

Cellulitis is a common medical emergency. Investigations often fail to establish the specific microbial aetiology and there are few data to support common choices of antibiotic therapy used to treat cellulitis. Potentially unusual pathogens can be predicted from the epidemiological circumstances at presentation, while empirical treatment choices must be based on an understanding of the underlying pharmacokinetic and pharmacodynamic principles that govern antibiotic-microbe interactions. Animal models have established conditions that predict treatment success, taking into account confounding factors such as bacterial inoculum size. Synergistic combinations of antibiotics can improve outcome in difficult cases.

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