Cellulitis Flashcards
What is non-purulent cellulitis?
intact skin, no drainage, no exudate, no abscess
What is the pre-dominant bacteria in non-purulent cellulitis?
Strep. pyogenes
What is the predominant bacteria in purulent cellulitis?
Staph. aureus
Signs/symptoms of cellulitis?
lesion: hot/warm to tough
usually red
skin tightness, swollen
1st line to treat mild-moderate cellulitis?
cephalexin po for 7-10 days
if patient is allergic to penicillins, what is the alternative?
clindamycin 300 mg qid for 7 days or
erythromycin base (adults)
or
estolate (in children) 1 g bid to qid for 7 days
2nd line drug option?
cefuroxime
if patient is hospitalized with severe cellulitis, what is the drug option?
cefazolin IV +/- clindamycin po OR cefazolin + probenecid po
2nd line: clindamycin IV or doxycycline IV
If patient is hospitalized and is allergic to beta lactams and MRSA who do not respond to therapy, what drug option?
Vancomycin IV
Causative organisms of cellulitis?
S. aureus
B-hemolytic Streptococci
H. influenzae (in patients < 5 yo)
What are the risk factors of cellulitis?
-highest risk: history of cellulitis
-S. aureus or B-hemolytic strep in toe webs
-presence of leg erosions or ulcers
-prior saphenectomy
-tinea pedis interdigitalis
-obesity
-poor peripheral circulation
-immunocompromised (HIV, steroids)
-IV Drug abuse
Drug of choice in mild cellulitis + MRSA + purulent Cellulitis?
MSSA regimen (cephalexin or cefuroxime or clinda) + ADD SMX/TMP or po doxycycline
What are the symptoms of mod-severe cellulitis?
systemic - fever, HR > 90, RR > 24, leukocytosis, organ dysfunction, immunocompromised, deeper infection
purulent cellulitis + mild + MSSA ?
1st line: cephalexin or cefuroxime
if allergies: clindamycin
purulence + mod-severe + MSSA ?
IV cefazolin, IV clindamycin, IV cloxacillin
