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Suggested Antimicrobial Regimen
Cellulitis is caused by Strep > Staph
If it looks like erysipelas, it is almost certainly caused by Group A Strep
Erysipelas
Erysipelas is infection confined to the superficial epidermis and lymphatics
It is bright red, painful - “burning”, sharply demarcated, with a raised edge and induration
Classic areas include the face and bridge of nose, but often occurs on the extremities, particularly in the setting of lymphatic damage
Recurrence is common
Blood culture low yield unless there is SIRS
SIRS
SIRS = Two of:
HR>90, RR >20 or PaCO2 <32, Temp >38 or <36, WBC >12 or <4
Bilateral lower limb cellulitis is rare- consider venous stasis or dependent rubor.
The redness of cellulitis should NOT resolve with elevation of the limb.
Day 3 bundle