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Consult an interventionalist-radiologist or a surgeon for diagnostic exploration in patients with serious soft tissue infections.  |
- Consult an interventionalist-radiologist to aspirate deep collections and to biopsy deep lesions for microbiologic and histologic evaluation.
- Obtain prompt surgical consultation in patients who have cellulitis or soft tissue infection with the following:
- Fluctuance or crepitus on exam
- Purple bullae, ecchymoses, or sloughing of skin
- Recent trauma, surgery, or childbirth
- Evidence of compartment syndrome
- Increasingly severe pain, with or without fever
- Gas in the tissue or other signs of necrotizing fasciitis or clostridial myonecrosis on CT or MRI scans
- Surgically explore and inspect the fascia and muscle and drain any abscesses.
- Send material for histopathology, Gram stain, culture, and sensitivity; for immunosuppressed patients, send material for fungal, mycobacterial, and viral tests where appropriate.
- Recognize that repeated surgical debridement and subsequent plastic or reconstructive surgery may be necessary.
| Background
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| Dennis L. Stevens, PhD, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Lawrence J. Eron, MD, FACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
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Cellulitis and Soft Tissue Infections
