Infectious diseases - Skin and soft tissue infections

Question 1

Presentation of cellulitis

Answer 1

Erythema

Warmth

Tense, Thickened skin

Oedematous

Bullae (fluid-filled blisters)

A golden-yellow crust can be present and indicate a staphylococcus aureus infection

Question 2

Most common causes of cellulitis

Answer 2

Staphylococcus aureus

Group A strep (mainly Strep pyogenes)

Group C Streptococcus (mainly Streptococcus dysgalactiae)

Also MRSA

Question 3

What classification system is used for assessing cellulitis severity?

Answer 3

Eron Classification

Class 1 – no systemic toxicity or comorbidity
Class 2 – systemic toxicity or comorbidity
Class 3 – significant systemic toxicity or significant comorbidity
Class 4 – sepsis or life-threatening

Admit class 3 and 4 for IV Abx

Question 4

What is the first choice for cellulitis? Alternatives?

Answer 4

Flucloxacillin (first line)

Alternatives:

• Clarithromycin
• Clindamycin
• Co-amoxiclav