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Summary
Bacterial cultures from skin aspirates are rarely positive in acute cellulitis cases. Needle aspiration is most beneficial for immunocompromised patients or those with severe symptoms, offering a low diagnostic yield in otherwise healthy individuals.
Area of Science:
- Infectious Diseases
- Dermatology
- Microbiology
Background:
- Acute cellulitis is a common bacterial skin infection.
- Diagnostic methods for cellulitis often include microbial cultures.
- The utility of needle aspiration in diagnosing cellulitis is debated.
Purpose of the Study:
- To evaluate the diagnostic yield of needle aspiration in acute cellulitis.
- To identify patient subgroups who may benefit from needle aspiration.
- To assess the safety and efficacy of empiric antimicrobial therapy.
Main Methods:
- Retrospective chart review of twenty consecutive acute cellulitis patients.
- Inclusion criteria: suffusion and edema; exclusion criteria: skin breaks, suppuration, prior antibiotics.
- Analysis of aspirate and blood cultures, and patient response to therapy.
Main Results:
- Nineteen of twenty (95%) aspirates yielded no microbial growth.
- One immunocompromised patient grew Pasteurella multococida from aspirate and blood.
- All patients responded to empiric antimicrobial therapy; needle aspiration was safe.
Conclusions:
- Needle aspiration has a low diagnostic sensitivity for acute cellulitis in general.
- Aspiration is indicated for immunocompromised patients, children with facial cellulitis, open wounds, or treatment failures.
- Empiric antimicrobial therapy is effective for most acute cellulitis cases.