Skin and Soft Tissue Infections in the Emergency Department

Area of Science:

• Emergency Medicine
• Infectious Diseases
• Dermatology

Background:

• Skin and soft tissue infections (SSTIs) are frequent in emergency departments.
• Accurate diagnosis and timely treatment are crucial for patient outcomes.
• Distinguishing between purulent and nonpurulent SSTIs impacts therapeutic decisions.

Purpose of the Study:

• To provide a diagnostic and treatment overview of common SSTIs encountered in emergency settings.
• To emphasize key management strategies for various SSTI types.
• To highlight the importance of early recognition and intervention for severe infections.

Main Methods:

• Review of common SSTIs: impetigo, cutaneous abscesses, purulent cellulitis, nonpurulent cellulitis, and necrotizing SSTIs.
• Discussion of causative pathogens, focusing on methicillin-resistant Staphylococcus aureus (MRSA) and streptococcal species.
• Emphasis on diagnostic criteria and treatment modalities, including incision and drainage, and surgical debridement.

Main Results:

• Purulent infections in the US are often caused by MRSA; incision and drainage are key for abscesses.
• Nonpurulent infections typically stem from streptococci; empiric antibiotics may not require MRSA coverage.
• Necrotizing SSTIs require rapid diagnosis and prompt surgical intervention.

Conclusions:

• Effective management of SSTIs hinges on accurate differentiation of infection types and appropriate, timely interventions.
• Prompt surgical exploration is critical for potentially lethal necrotizing SSTIs.
• Understanding common pathogens guides empiric antibiotic selection for purulent versus nonpurulent SSTIs.