Soft Tissue Infections

Cellulitis is an acute, spreading infection of the deep dermis and subcutaneous fat characterized by erythema, warmth, swelling, and pain. Erysipelas is an infection of the more superficial cutaneous lymphatics and skin, including the epidermis as well as the upper reticular and papillary dermal layers. It is commonly located on the lower extremities, face, and ears. Cutaneous abscesses are purulent collections that occupy the dermis and deeper soft tissues. Effective treatment of cellulitis and erysipelas includes antibiotics and elevation of the affected area to assist in lymphatic drainage. Methicillin-resistant Staphylococcus aureus (MRSA) infection should be considered in all cellulitis or erysipelas patients who have failed initial therapy, have a history of or risk factors for MRSA, or have severe infection or systemic toxicity. The first-line treatment for a cutaneous abscess is incision and drainage (I&D); no data demonstrates the utility of antibiotic therapy in conjunction with I&D.