flashcards_cellulitis
How can uncomplicated cellulitis be managed?
Uncomplicated cellulitis can be managed at home with oral antibiotics.
What is the management for complicated cellulitis?
Complicated cellulitis may require admitting, resuscitation with oxygen and fluids, and IV antibiotics. Switch to oral when fever settles, cellulitis has regressed, and CRP is reducing.
When should cellulitis patients be admitted?
Admit if class III or IV cellulitis, severe or rapidly deteriorating cellulitis, aged under 1, immunocompromised, significant lymphoedema, facial cellulitis (unless very mild), suspected orbital or periorbital cellulitis (admit to ophthalmology), symptoms/signs suggesting more serious illness or condition, or consider in class II cellulitis if no facilities/expertise available in the community.
What are the PACES tips for explaining the diagnosis and management of cellulitis?
Explain the diagnosis (characterized by dry, itchy skin), explain that it is very common, and many children grow out of it, explain the management (and use of steroids if necessary), encourage frequent, liberal use of emollients (and as a soap substitute), explain the association with other atopic conditions, advise avoidance of triggers, avoid scratching if possible, safety net about signs of infection, provide information and support resources.
What is the treatment for severe cellulitis?
IV flucloxacillin (or clarithromycin if penicillin allergic). Alternatives: co-amoxiclav, cefuroxime, clindamycin, ceftriaxone.
What is the treatment for non-severe cellulitis?
Oral flucloxacillin (clarithromycin if penicillin allergic). Alternatives: clarithromycin, doxycycline.
What is the treatment for cellulitis near the eyes or nose?
Co-amoxiclav oral or IV (according to severity). Alternatives: clarithromycin AND metronidazole.
When should a review be arranged for cellulitis patients?
After 2-3 days depending on clinical judgement and/or deterioration.
What surgical interventions may be needed for cellulitis?
Surgery for incision and drainage of abscess, debridement of necrotic tissue, or treatment of compression syndromes.
Who should be involved in an MDT approach for cellulitis management?
Dermatologists, microbiology, pharmacists, surgeons, and ophthalmologists if (peri)orbital cellulitis.
What can be used to relieve pain or discomfort in cellulitis?
Paracetamol or ibuprofen.
How does erysipelas present and how is it treated?
Erysipelas presents with a very clearly demarcated rash and is treated with penicillin V.
