Signs

• Both erysipelas and cellulitis are manifested by rapidly spreading areas of redness, edema, and heat. Lymphangitis and regional lymphadenopathy may be observed

• Important clinical differences between erysipelas and cellulitis exist:

• In erysipelas, low-grade fever and flu-like illness are common prior to development of the lesion. The lesion is fiery red, raised above the level of surrounding skin, and has well-defined borders

• In cellulitis, the lesion is not raised and has poorly defined margins Laboratory Tests

• Leukocytosis may be present

• Cultures and sensitivities:

• Blood cultures are only positive about 4% of the time but should be obtained for complicated or severe cases. Cultures aspirated from the lesion have an organism isolation rate of less than 20%, but also may be considered

• Abscess drainage and debrided tissue, if obtainable, should be cultured and will yield the causative organism(s) up to 90% of the time

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