A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting
Abstract
:1. Introduction
2. Background
3. Discussion
3.1. Conceptual Frameworks for SSTIs
3.2. History of Present Illness (HPI)
3.3. Physical Exam
3.4. Imaging
3.5. Laboratory Studies
3.6. Principles of Treatment
3.7. Hospitalization
3.8. Adjuvant Therapies
4. Diagnosis and Treatment
4.1. Impetigo
4.2. Ecthyma
4.3. Folliculitis
4.4. Abscesses
Recurrent Abscesses
4.5. Cellulitis
Recurrent Cellulitis
4.6. Erysipelas
4.7. Necrotizing Infections
4.8. Special Situations
4.8.1. Bite Wounds
4.8.2. Other SSTIs and Mimics
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Sartelli, M.; Guirao, X.; Hardcastle, T.; Kluger, Y.; Boermeester, M.A.; Rasa, K.; Ansaloni, L.; Coccolini, F.; Montravers, P.; Abu-Zidan, F.M.; et al. 2018 WSES/SIS-E consensus conference: Recommendations for the management of skin and soft tissue infections. World J. Emerg. Surg. 2018, 13, 58. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chahine, E.B.; Sucher, A.J. Skin and Soft Tissue Infections; Murphy, J.E., Lee, M.W., Eds.; Pharmacotherapy Self-Assessment Program, Book 1 (Infectious Diseases); ACCP: Lenexa, KS, USA, 2015; pp. 5–27. [Google Scholar]
- Ramakrishnan, K.; Salinas, R.C. Skin and soft tissue infections. Am. Fam. Phys. 2015, 92, 474–483. [Google Scholar]
- Rajan, S. Skin and soft-tissue infections: Classifying and treating a spectrum. Clevel. Clin. J. Med. 2012, 79, 57–66. [Google Scholar] [CrossRef] [PubMed]
- Ki, V.; Rotstein, C. Bacterial skin and soft tissue infections in adults. Can. J. Infect. Dis. Med. Microbiol. 2008, 19, 173–184. [Google Scholar] [CrossRef] [Green Version]
- Miller, J.; Leib, A. Reducing morbidity and mortality due to MRSA in the urgent care setting. J. Urgent Care Med. 2020, 14, 11–15. [Google Scholar]
- Jeng, A.; Beheshti, M.; Li, J.; Nathan, R. The role of β-hemolytic streptococci in causing diffuse, nonculturable cellulitis. Medicine 2010, 89, 217–226. [Google Scholar] [CrossRef]
- Lipsky, B.A.; Silverman, M.H.; Joseph, W.S. A proposed new classification of skin and soft tissue infections modeled on the subset of diabetic foot infection. Open Forum Infect. Dis. 2017, 4, ofw255. [Google Scholar] [CrossRef]
- May, A.K.; Stafford, R.E.; Bulger, E.M.; Heffernan, D.; Guillamondegui, O.; Bochicchio, G.; Eachempati, S.R. Treatment of complicated skin and soft tissue infections. Surg. Infect. 2009, 10, 467–499. [Google Scholar] [CrossRef] [Green Version]
- Eron, L.J.; Lipsky, B.A.; Low, D.E.; Nathwani, D.; Tice, A.D.; Volturo, G.A. Managing skin and soft tissue infections: Expert panel recommendations on key decision points. J. Antimicrob. Chemother. 2003, 52 (Suppl. 1), i3–i17. [Google Scholar] [CrossRef] [Green Version]
- Koerner, R.; Johnson, A.P. Changes in the classification and management of skin and soft tissue infections. J. Antimicrob. Chemother. 2011, 66, 232–234. [Google Scholar] [CrossRef]
- Bystritsky, R.; Chambers, H. Cellulitis and soft tissue infections. Ann. Int. Med. 2018, 168, ITC17-32. [Google Scholar] [CrossRef] [PubMed]
- Eron, L.J.; Laine, C.; Goldmann, D.R.; Sox, H.C. Cellulitis and soft-tissue infections. Ann. Int. Med. 2009, 150, ITC1-16. [Google Scholar]
- Stevens, D.L.; Bisno, A.L.; Chambers, H.F.; Dellinger, E.P.; Goldstein, E.J.C.; Gorbach, S.L.; Hirschmann, J.; Kaplan, S.L.; Montoya, J.G.; Wade, J.C. Practice guidelines for the diagnosis and management of skin and soft tissue infections [IDSA 2014 guidelines]. Clin. Infect. Dis. 2014, 59, e10–e52. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Silversides, J.A.; Lappin, E.; Ferguson, A.J. Staphylococcal toxic shock syndrome: Mechanisms and management. Curr. Infect. Dis. Rep. 2010, 12, 392–400. [Google Scholar] [CrossRef]
- Moffarah, A.S.; Al Mohajer, M.; Hurwitz, B.L.; Armstrong, D.G. Skin and soft tissue infections. Microbiol. Spectr. 2016, 4, 691–708. [Google Scholar] [CrossRef]
- Bailey, E.; Kroshinsky, D. Cellulitis: Diagnosis and management. Dermatol. Ther. 2011, 24, 229–239. [Google Scholar] [CrossRef]
- Burnham, J.P.; Kollef, M.H. Treatment of severe skin and soft tissue infections: A review. Curr. Opin. Infect. Dis. 2018, 31, 113–119. [Google Scholar] [CrossRef]
- Leong, H.N.; Kurup, A.; Tan, M.Y.; Kwa, A.L.H.; Liau, K.H.; Wilcox, M.H. Management of complicated skin and soft tissue infections with special focus on the role of newer antibiotics. Infect. Drug Resist. 2018, 11, 1959–1974. [Google Scholar] [CrossRef] [Green Version]
- Prokuski, V.; Strohl, A. Soft tissue coverage for severe infections. Hand Clin. 2020, 36, 369–379. [Google Scholar] [CrossRef]
- Yamamoto, L.G. Treatment of skin and soft tissue infections. Pediatr. Emerg. Care 2017, 33, 49–57. [Google Scholar] [CrossRef]
- Diefenbeck, M.; Mennenga, U.; Gückel, P.; Tiemann, A.H.; Mückley, T.; Hofmann, G.O. Vacuum-assisted closure therapy for the treatment of skin and soft-tissue infections. Are wound specimens of use in planning secondary wound closure? Z. Orthop. Unf. 2011, 149, 324–329. [Google Scholar] [CrossRef] [PubMed]
- Peinemann, F.; Labeit, A. Negative pressure wound therapy: A systematic review of randomized controlled trials from 2000 to 2017. J. Evid. Based Med. 2019, 12, 125–132. [Google Scholar] [CrossRef] [PubMed]
- Impetigo: Antimicrobial Prescribing. Natl. Inst. Health Care Excell. (NICE) 2020. Available online: https://www.nice.org.uk/guidance/ng153 (accessed on 18 January 2021).
- Brindle, R.; Williams, O.M.; Barton, E.; Featherstone, P. Assessment of antibiotic treatment of cellulitis and erysipelas. JAMA Dermatol. 2019, 155, 1033–1040. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fogo, A.; Kemp, N.; Morris-Jones, R. PVL positive Staphylococcus aureus skin infections. BMJ 2011, 343, d5343. [Google Scholar] [CrossRef]
- Tascini, C.; Tagliaferri, E.; Rossolini, G.M.; Mantengoli, E.; Mirarchi, G.; Leonildi, A.; Polidori, M.; Menichetti, F. Cellulitis caused by a methicillin-sensitive Staphylococcus aureus isolate harboring Panton-Valentine toxin in an American soldier returning from Iraq. Int. J. Dermatol. 2011, 50, 206–207. [Google Scholar] [CrossRef]
- Schürmann, D.; Hoffmann, C.; Stegemann, M.S.; Ruwwe-Glösenkamp, C.; Gürtler, L. HIV transmission by human bite: A case report and review of the literature—Implications for post-exposure prophylaxis. Infection 2020, 48, 949–954. [Google Scholar] [CrossRef]
- Rerucha, C.M.; Ewing, J.T.; Oppenlander, K.E.; Cowan, W.C. Acute hand infections. Am. Fam. Phys. 2019, 99, 228–236. [Google Scholar]
- Falagas, M.E.; Vergidis, P.I. Narrative review: Diseases that masquerade as infectious cellulitis. Ann. Int. Med. 2005, 142, 47–55. [Google Scholar] [CrossRef]
General Risk Factors | Risk Factors for MRSA Infections |
---|---|
|
|
|
|
|
|
|
|
|
|
|
|
| |
| Risk factors for NF |
|
|
|
|
|
|
|
|
|
|
Purulent | Non-Purulent | |
---|---|---|
Mild |
|
|
Moderate/severe |
|
|
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Silverberg, B. A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting. Clin. Pract. 2021, 11, 65-74. https://doi.org/10.3390/clinpract11010011
Silverberg B. A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting. Clinics and Practice. 2021; 11(1):65-74. https://doi.org/10.3390/clinpract11010011
Chicago/Turabian StyleSilverberg, Benjamin. 2021. "A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting" Clinics and Practice 11, no. 1: 65-74. https://doi.org/10.3390/clinpract11010011
APA StyleSilverberg, B. (2021). A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting. Clinics and Practice, 11(1), 65-74. https://doi.org/10.3390/clinpract11010011