Approach to the Patient with Cellulitis

Approach to the Patient with Cellulitis - Flowchart

«Flowchart»

Patient with Cellulitis

Consider associated foreign body

Staphylococci^*
Streptococci

^* ^*

Staphylococci^*
Streptococci
Gram-negative rods
Nosocomial organisms
Atypical mycobacteria
Opportunistic fungi, including:

Cryptococcus
Mucor
Aspergillus

Staphylococci^*
Streptococci
Gram-negative rods
Nosocomial organisms
Atypical mycobacteria
Opportunistic fungi, including:

Cryptococcus
Mucor
Aspergillus

Staphylococci^*
Streptococci
Gram-negative rods
Nosocomial organisms
Atypical mycobacteria
Opportunistic fungi, including:

^* ^*

Cryptococcus
Mucor
Aspergillus

Cryptococcus Cryptococcus
Mucor Mucor
Aspergillus Aspergillus

Staphylococci^*
Streptococci
Gram-negative rods

^* ^*

Search for signs of deeper involvement (necrotizing fasciitis; myositis)

Normal hosts

Mild to moderate immunosuppression

Diabetes mellitus
Low-dose systemic corticosteroids (prednisone <20 mg daily)

Mild to moderate immunosuppression

Diabetes mellitus
Low-dose systemic corticosteroids (prednisone <20 mg daily)

Diabetes mellitus
Low-dose systemic corticosteroids (prednisone <20 mg daily) Mild to moderate immunosuppression

Severe immunosuppression

Neutropenia
High-dose corticosteroids
Immunosuppressive agents

Severe immunosuppression

Neutropenia
High-dose corticosteroids
Immunosuppressive agents

Neutropenia
High-dose corticosteroids
Immunosuppressive agents Severe immunosuppression

End

^*Need to consider methicillin-resistant Staphylococcus aureus (MRSA)

^* Staphylococcus aureus