Cellulitis laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Aditya Govindavarjhulla, M.B.B.S.
Overview
With changing trends in medicine, recommended lab investigations are changing. Blood cultures and blood counts are the mainstay for the treatment and prognosis of cellulitis. Other blood tests such as ESR and CRP assist in prognosis. Levels of ESR and CRP taken at a patient's admission may predict the severity and duration of hospitalization. [1]
Laboratory Findings
Blood tests
- Total blood count increases. Leukocytosis is seen in most of the cellulitis cases, but in a few toxin mediated cellulitis cases leucopenia may be observed.
- ESR and CRP can be used as prognostic indicators. New recommendations are more favorable towards the use of CRP compared to ESR as an indicator of infection severity.[2]
- If repeated infections of cellulitis occur, diabetes should be ruled out as a cause. Blood glucose levels will assist in determining if diabetes has had any influence on the development of cellulitis.
Staining and cultures
- Cultures can be taken from wounds, pus and blood. Blood cultures are positive only in few cases of mild infection and community acquired cellulitis. [3] Blood cultures become a significant diagnostic tool when the inflammation present in cellulitis spreads systemically.
- In cases where an abscess has formed, gram staining and cultures of the drained fluid may be helpful in further management of the condition.
- In cases of reoccurring cellulitis of the foot, fungal infections have to be ruled out. Skin scrapings will be helpful for the diagnosis.
Drug Resistance
- Microbial resistance to drugs is a very common and serious problem.[4] In cases of non resolution, severe infections leading to hospitalization drug sensitivity has to be tested.
References
- ↑ Lazzarini L, Conti E, Tositti G, de Lalla F (2005). "Erysipelas and cellulitis: clinical and microbiological spectrum in an Italian tertiary care hospital.". J Infect 51 (5): 383-9. doi:10.1016/j.jinf.2004.12.010. PMID 16321649.
- ↑ http://dermatology.jwatch.org/cgi/content/full/2011/318/1
- ↑ Perl B, Gottehrer NP, Raveh D, Schlesinger Y, Rudensky B, Yinnon AM (1999). "Cost-effectiveness of blood cultures for adult patients with cellulitis.". Clin Infect Dis 29 (6): 1483-8. doi:10.1086/313525. PMID 10585800.
- ↑ http://www.nejm.org/doi/full/10.1056/nejmoa043252
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