Costs and Consequences Associated With Misdiagnosed Lower Extremity Cellulitis

Area of Science:

• Dermatology
• Infectious Diseases
• Health Economics

Background:

• Inflammatory dermatoses of the lower extremity are frequently misdiagnosed as cellulitis, termed pseudocellulitis.
• This misdiagnosis often results in unnecessary antibiotic treatment and hospitalizations.
• Limited data exists on the financial and complication-related burdens of misdiagnosed cellulitis.

Purpose of the Study:

• To determine the national healthcare burden associated with misdiagnosed cellulitis in patients admitted for lower extremity cellulitis.
• To quantify the costs and complications arising from pseudocellulitis misdiagnosis.

Main Methods:

• A cross-sectional study analyzed patients admitted with lower extremity cellulitis from June 2010 to December 2012.
• Patients were categorized as cellulitis or pseudocellulitis based on discharge diagnoses.
• National cost data from the Medical Expenditure Panel Survey (MEPS) was used to estimate annual healthcare spending.

Main Results:

• Approximately 30.5% of patients were misdiagnosed with cellulitis (pseudocellulitis).
• Of those admitted, 84.6% did not require hospitalization, and 92.3% received unnecessary antibiotics.
• Estimated annual costs range from $195 million to $515 million, with 50,000 to 130,000 unnecessary hospitalizations.

Conclusions:

• Misdiagnosis of lower extremity cellulitis is a prevalent issue.
• This misdiagnosis leads to significant unnecessary patient morbidity and substantial healthcare expenditures.
• Addressing pseudocellulitis misdiagnosis can reduce patient harm and healthcare costs.