Episode 69 – Cellulitis and Other Skin and Soft Tissue Infections

In this episode, Sam Ashoo, MD interviews Kyle Howarth, MD and Joby Thoppil, MD, PhD - two of the authors of the May, 2022 EMP article on Cellulitis and Skin and Soft Tissue Infections. Listen to the discussion to hear more about the emergency department management of cellulitis and necrotizing skin infections. Episode 69 – Emergency Department Management of Cellulitis and Other Skin and Soft-Tissue Infections   EMplify – May 2022  Episode Outline:  Why cellulitis/skin infections?  Terminology Erysipelas vs cellulitis vs fasciitis  Purulent cellulitis Most common pathogens Special situations  Necrotizing infection classification system – is this helpful in the ED, and if so, why? Differential – unilateral vs bilateral presentation Prehospital care  ED evaluation History – what should we be asking? Examination: SSTI vs NSTI Diagnostics POCUS: “cobblestoning” and fluid collection Xray: subcutaneous gas CT: when is this helpful? Labs Blood cultures – if given the option, are they helpful? Wound cultures – any role for these?  Routine labs (CBC, BMP, etc) – are they helpful? LRINEC score – what is it and should we be using it? Treatment  NSTI antibiotics Abscesses Special populations IV drug users Diabetic patients Immunocompromised patients Wound irrigation and loop drainage Disposition