Cellulitis: diagnosis and management

Area of Science:

• Dermatology
• Infectious Diseases

Background:

• Cellulitis is an acute bacterial infection affecting the dermis and subcutaneous skin layers.
• It frequently occurs post-trauma and is a common diagnosis in various clinical settings.
• Classic signs include erythema, swelling, warmth, and tenderness, necessitating a broad differential diagnosis.

Purpose of the Study:

• To review the clinical presentation of cellulitis.
• To discuss common differential diagnoses that mimic cellulitis.
• To outline diagnostic approaches and treatment strategies for cellulitis.

Main Methods:

• Review of clinical presentation and diagnostic criteria for cellulitis.
• Comparison with common dermatologic mimics such as venous stasis dermatitis, contact dermatitis, deep vein thrombosis, and panniculitis.
• Discussion of diagnostic aids including history, physical examination, laboratory tests, and skin biopsy.
• Overview of outpatient antibiotic treatment options.

Main Results:

• Cellulitis presents with characteristic erythema, swelling, warmth, and tenderness.
• Mimics like dermatitis and deep vein thrombosis share overlapping symptoms, requiring careful differentiation.
• Diagnostic tools aid in distinguishing cellulitis from its mimics.
• Oral antibiotics like dicloxacillin or cephalexin are primary treatments for uncomplicated cases.

Conclusions:

• Accurate diagnosis of cellulitis is crucial due to potential mimics.
• A thorough evaluation combining clinical findings and diagnostic tests is essential.
• Outpatient oral antibiotic therapy is effective for most cellulitis cases when methicillin-resistant Staphylococcus aureus is not suspected.