Cellulitis, erysipelas

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1. Erysipelas

    1. sharp border

    2. painful

    3. strep

2. Cellulitis

    1. dermis and subcutaneous are involved

    2. vague border

    3. staph

    4. mostly in DM, malnutrition, immunodeficiency, trauma, fly bite

3. Treatment: if high risk, start IV treatment then change into PO treatment

    1. Cold compress

    2. Cap mefenamic acid tds

    3. Vial ceftriaxone 1gr (50-75mg/kg) qd

        1. or Vial cefazolin 1gr q8h (100mg/kg/day)

    4. Vial vancomycin 1gr q12h (15mg/kg/day)

        1. or cap cefalexin 500 mg qid

        2. or susp cefalexin 250, 125mg/5ml

        3. or tab erythromycin 400 mg

        4. or tab penicillin 500 mg qid

    5. treat for 7 days, start with IV then change to Po

    6. always consider necrotizing fasciitis

4. Prophylaxis for recurrent cellulitis

    1. Cap penicillin v 500 mg q12h #30

5. for septal cellulitis, always admit and use IV antibiotics

    1. diplopia

    2. proptosis

    3. vision loss