Cellulitis and Soft Tissue Infections

1
Cellulitis and Soft Tissue Infections

• Pamela Orr
• Professor, Internal Medicine, Medical
  Microbiology and Community Health Sciences

2
(No Transcript)
3
(No Transcript)
4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
Investigation

• Blood cultures if fever history/objective
  fever/chills/systemic symptoms or
  signs/immunosuppressed
• Check for Tinea pedis if lower extremity involved
• Culture any open wounds (including anaerobic
  culture if deep or necrotic or malodorous)
• CBC, urea, creatinine, glucose
• Image eg. CT of orbit and brain
• Incise and drain and pack !!

18
Treatment

• Cellulitis not associated with wound usually
  Streptococcus A (B/C/G) / MSSA/ MRSA (or Strep
  Pneumoniae or Haemophilus influenzae in orbital
  cellulitis)
• iv Ceftriaxone 2 gm/day /- iv Vancomycin
• Pen allergy iv Clindamycin or Vancomycin
• Oral Cloxacillin or Cephalexin (or Clinda if Pen
  allergic) - add Septra or Doxycycline if MRSA is
  suspected
• Cefuroxime-axetil in orbital cellulitis
• Eryripelas Strep A
• iv Ceftriaxone (or Pen or Ampicillin)
• Pen Allergy iv Clindamycin (or Vanco)
• Oral Penicillin V or Amoxil (or Clinda if Pen
  allergic)

19
Treatment

• Diabetic Foot Infection usually mixed gram
  /-/anaerobes. Decide whether osteomyelitis is
  present, and assess arterial pulses. Often needs
  iv therapy. Start with (after cultures)
• eg. iv Ceftriaxone iv Vanco po Metronidazole
• eg. po Amoxicillin/Clavulinic Acid /- Doxy, or
  po Septra Metro
• Wound Infection likley mixed infection, as
  above. Same approach. If Water exposure think of
  Pseudomonas use Ceftazidime or Ciprofloxacin
  instead of Ceftriaxone
• Head and Neck Region Infections Be very cautious
  

20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)