Cellulitis
Nonpurulent cellulitis is associated with the four cardinal signs of infection, as follows:
- Erythema, pain, swelling, warmth
The following findings suggest severe infection:
- Malaise, chills, fever, and toxicity
- Lymphangitic spread (red lines streaking away from the area of infection)
- Circumferential cellulitis
- Pain disproportionate to examination findings
The IDSA recommends considering inpatient admission in patients with hypotension and/or the following laboratory findings :
- Elevated creatinine level Elevated creatine phosphokinase level (2-3 times the upper limit of normal)
- CRP level >13 mg/L (123.8 mmol/L)
- Low serum bicarbonate level
- Marked left shift on the CBC with differential
Consider surgical intervention in,
- Violaceous bullae
- Cutaneous hemorrhage
- Skin sloughing
- Skin anesthesia
- Rapid progression
- Gas in the tissue
- Hypotension