Fast Five Quiz: Cellulitis

Mary L. Windle, PharmD


May 22, 2023

Urgent surgical consultation is indicated in the setting of circumferential cellulitis, crepitus, evolving bullae, necrotic-appearing skin (bronzing), pain disproportionate to findings on physical examination, severe pain on passive movement, rapidly evolving cellulitis, or other clinical concerns for necrotizing fasciitis. Because circumferential cellulitis can cause compartment syndrome, compartment pressure measurements may assist in diagnosis.

Adequate treatment of cellulitis associated with an abscess requires surgical drainage of the source of infection. Loop drainage is preferred to more traditional incision and drainage techniques. Serious concerns based on presence of necrotic skin or indicia of necrotizing fasciitis should prompt immediate examination of the fascial planes directly by an experienced surgeon at the bedside or by CT. This imaging may help confirm a necrotizing fasciitis diagnosis; however, it should not delay surgical intervention. Results that reveal subcutaneous gas in soft tissue are highly specific for necrotizing fasciitis.

Learn more about skin and soft-tissue infections.

This Rapid Review Quiz was excerpted and adapted from the Medscape articles: Cellulitis, Cellulitis Empirical Therapy, Blood Culture, Cellulitis Organism-Specific Therapy, Delafloxacin, and Skin and Soft Tissue Infections — Incision, Drainage, and Debridement.

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