Rationale:

• Because a wide variety of bacteria, fungi, parasites, and viruses can cause soft tissue infection, a careful history is important in determining the cause of the infection. For example, a history of a cat bite provides useful information, suggesting that infection by P. multocida is possible.
• Increasing pain at the site of previous injury, accompanied by fever, rigors, and confusion, suggests that the condition may be a severe infection with systemic complications and that hospitalization is appropriate to monitor the patient.

Evidence:

• An expert panel issued recommendations on key points for managing skin and soft tissue infections (33).
• The Infectious Diseases Society of America has published guidelines for the diagnosis and management of skin and soft tissue infections (21).

Comments:

• An accurate and timely diagnosis and identification of the cause will lead to early and appropriate antimicrobial treatment. Given early in the course of infection, antimicrobials can minimize the severity of disease.