The value of needle aspiration in the management of cellulitis

Needle aspirations from 103 young, healthy patients (mean age 22 years) with cellulitis were prospectively analyzed to determine the percentage yield and causative organisms. A standard technique of needle aspiration was performed using a 22-gauge needle, a 10-cc syringe, and 1 cc of sterile water. Aspirations were performed at the leading edge and midpoint of the cellulitis (halfway between the leading edge and the center of the cellulitis). Fifteen of the 103 patients (14.5 percent) had positive aspirates. Nine of the 103 aspirates were positive at the leading edge (8.7 percent) and 6 of 70 were positive at the midpoint (8.6 percent), giving a total aspiration positivity of 8.7 percent (15/173). The organisms recovered were Staphylococcus aureus (53 percent). Staphylococcus epidermidis (27 percent), alpha-hemolytic streptococci (13 percent) and Streptococcus pyogenes (7 percent). The low-percentage yield and predictable organisms recovered speak against needle aspiration being a necessary procedure in a young, healthy population. Similarly, the site of aspiration does not increase yield. Empiric treatment with antibiotics aimed at staphylococcal and streptococcal organisms is appropriate.