How are adult patients categorized for the empiric treatment of cellulitis?

Updated: Sep 13, 2018
  • Author: Alfred Scott Lea, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

The empiric treatment of cellulitis in adults begins with the categorization of patients into one of the following categories:

  • Nonpurulent cellulitis: Includes rapidly spreading superficial cellulitis and erysipelas; typically involves groups A, B, C, and G beta-hemolytic streptococci and, occasionally, methicillin-susceptible Staphylococcus aureus (MSSA) ; these infections are diagnosed clinically, and cultures are not mandatory since there is usually no reliable and easily accessible source of specimen to culture [1, 2, 3, 4]

  • Purulent cellulitis: Includes cutaneous abscesses, carbuncles, furuncles, and sebaceous cyst infection typically involving S aureus, both MSSA and methicillin-resistant S aureus (MRSA); culture should be performed when possible to determine the pathogen’s presence and resistance pattern [1, 5, 6, 7, 8]


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