Cellulitis associated with bites or trauma, or with soil or water exposure

If trauma involves soil contamination, bacteria such as Pseudomonas, Enterobacteriaceae, Bacillus cereus, and fungi such as aspergillus can be implicated. Every attempt should be made to send tissue or fluid samples for bacterial and fungal cultures.

If trauma occurred in a water environment, other bacteria such as Aeromonas (freshwater or leeches) or Vibrio (seawater) in addition to Pseudomonas can also be present. Again, cultures should be obtained.

Ensure that the patient immunization status is up to date for tetanus but re-immunization is recommended.