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 (https://www.ebmedicine.net/topics/infectious-disease/emergency-medicine-skin). 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 (https://www.ebmedicine.net/topics/infectious-disease/emergency-medicine-skin (https://www.ebmedicine.net/topics/infectious-disease/emergency-medicine-skin))EMplify – May 2022Episode Outline:1. Why cellulitis/skin infections?2. Terminology* Erysipelas vs cellulitis vs fasciitis* Purulent cellulitis3. Most common pathogens4. Special situations5. Necrotizing infection classification system – is this helpful in the ED, and if so, why?6. Differential – unilateral vs bilateral presentation7. Prehospital care8. ED evaluation* History – what should we be asking?* Examination: SSTI vs NSTI9. Diagnostics* POCUS: “cobblestoning” and fluid collection* Xray: subcutaneous gas* CT: when is this helpful?10. 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? 11. Treatment * NSTI antibiotics *  Abscesses 12. Special populations * IV drug users * Diabetic patients * Immunocompromised patients 13. Wound irrigation and loop drainage 14. Disposition