Cellulitis: A Review of Current Practice Guidelines and Differentiation from Pseudocellulitis

Area of Science:

• Dermatology
• Infectious Diseases

Background:

• Cellulitis is a frequent cause of skin-related hospitalizations, presenting diagnostic and therapeutic challenges across various clinical settings.
• Diagnosis relies on clinical presentation, lacking a definitive gold standard, and is complicated by numerous infectious and non-infectious mimics.
• Microbiological diagnosis is often limited by low culture specimen sensitivity.

Purpose of the Study:

• To review the diagnostic challenges and current treatment strategies for cellulitis.
• To emphasize appropriate antibiotic selection for uncomplicated cellulitis.

Main Methods:

• Literature review of diagnostic criteria and treatment guidelines for cellulitis.
• Analysis of common causative pathogens and effective antibiotic coverage.

Main Results:

• Typical cellulitis presents with acute redness, warmth, swelling, and tenderness.
• Differential diagnoses include venous stasis dermatitis, eczema, and erythema migrans.
• Most non-purulent cellulitis cases are caused by beta-hemolytic streptococci or methicillin-sensitive Staphylococcus aureus.

Conclusions:

• Oral antibiotics like penicillin, amoxicillin, or cephalexin are generally sufficient for uncomplicated cellulitis.
• Antibiotic coverage for community-acquired methicillin-resistant Staphylococcus aureus is typically not recommended for non-purulent cellulitis.