Definition

 Acute onset of superfi cial skin infection in an otherwise well, ambulant patient. 

Note that abscesses need incision and drainage as well as antibiotic treatment. 

Admission Criteria

• Clinical diagnosis of cellulitis
• Awaiting HITH transfer in < 24hrs
• Failed min 24 hrs oral therapy (relative)
• DVT unlikely clinically

Exclusion Criteria

• Major co-morbidities ie diabetes, peripheral vasc dis / DVT
• Bilateral cellulitis (liposclerosis more likely)
• Severe cellulitis involving orbital area, facial, perineal region
• Extensive tissue damage or sloughing
• Obvious subcutaneous collection requiring surgical drainage
• Chronic lymphoedema

Investigations

• FBE
• UEC
• Glucose 
• Consider ultrasound if in doubt about DVT or collection

Suggested Medications

Specific Observations

• Report any increasing redness, pain or swelling
• Report evidence of systemic infection / sepsis

Specific Management Issues

• HITH notification early if HITH is intended discharge destination
• General Medicine (AMU) registrar if HITH admission required. 
• Surgical consult if collection suspected that cannot be drained in ED (most skin abscesses can be drained in ED, as the ED reg or consultant first)

Discharge Criteria

• Afebrile (T <38 C)
• Follow – up arranged
• HITH arranged
• Independent in ADL

Hospital Admission Criteria

• Persisting systemic illness
• Progressing cellulitis
• Unclear diagnosis