Value of needle aspiration in bacteriologic diagnosis of cellulitis in adults

We prospectively studied 30 adult patients with cellulitis, including many who were hospitalized with significant underlying medical problems. Needle aspiration of both central and leading edge areas of their lesions was performed in an attempt to establish a bacteriologic diagnosis. Potential pathogens were isolated by this technique in only 10% of the patients. Neither site of aspiration was clearly superior in terms of culture yield. Because aspirate Gram stains and cultures so rarely provided useful bacteriologic information, they were seldom helpful in guiding antibiotic selection or in influencing the outcome of treatment in most patients. However, clinical information, as well as results of primary lesion cultures when obtainable, may be used to successfully select therapy in most cases of adult cellulitis. On the basis of our results, needle aspiration may not be justified as a routine diagnostic procedure for all adults with cellulitis, though it may still be useful in selected patients.