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Cellulitis and skin abscess: Clinical manifestations and diagnosis

Authors
Denis Spelman, MBBS, FRACP, FRCPA, MPH
Larry M Baddour, MD, FIDSA, FAHA
Section Editors
Daniel J Sexton, MD
Sheldon L Kaplan, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Cellulitis, abscess, or both are among the most common skin and soft tissue infections [1-3]. Cellulitis (which includes erysipelas) manifests as an area of skin erythema, edema, and warmth; it develops as a result of bacterial entry via breaches in the skin barrier [4]. A skin abscess is a collection of pus within the dermis or subcutaneous space. Misdiagnosis of these entities is common [5], and possible alternative diagnoses should be considered carefully. (See 'Differential diagnosis' below.)

The epidemiology, microbiology, clinical manifestations, and diagnosis of cellulitis and skin abscess will be reviewed here. Issues related to treatment of cellulitis and abscess are discussed separately. (See "Cellulitis and skin abscess in adults: Treatment".)

Issues related to skin and soft tissue infections associated with specific epidemiologic factors (such as diabetes, animal bites, and water exposure) are discussed separately. (See "Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities" and "Soft tissue infections due to dog and cat bites" and "Soft tissue infections following water exposure".)

Issues related to infection involving the gluteal area and perineum are discussed separately. (See "Intergluteal pilonidal disease: Clinical manifestations and diagnosis" and "Perianal and perirectal abscess".)

EPIDEMIOLOGY

Cellulitis is observed most frequently among middle-aged individuals and older adults. Erysipelas occurs in young children and older adults [6,7]. The incidence of cellulitis is about 200 cases per 100,000 patient-years [8]. Skin abscess may occur in healthy individuals with no predisposing conditions.

           

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Literature review current through: Jun 2017. | This topic last updated: Jun 22, 2017.
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