Ep 109 Skin and Soft Tissue Infections – Cellulitis, Skin Abscesses and Necrotizing Fasciitis

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 24 April 2018

⏱️ 81 minutes

🔗️ Recording | iTunes | RSS

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Summary

How do you distinguish cellulitis from the myriad of cellulitis mimics? At what point do we consider treatment failure for cellulitis? What is the best antibiotic choice for patients who are allergic to cephalosporins? Which patients with cellulitis or skin abscess require IV antibiotics? Coverage for MRSA? What is the best and most resource wise method for analgesia before I&D of a skin abscess? What is the best method for drainage of a skin abscess? Which patients with skin abscess require a swab? Irrigation? Packing? Antibiotics? With the goal of sharpening your diagnostic skills when it comes to skin and soft tissue infections – there are lots of cellulitis mimics - and choosing wisely when it comes to treatment, we’ll be discussing best practices for management of cellulitis and skin abscesses, when to cover for MRSA, how to pick up nec fasc before it’s too late and a lot more…

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast with your host, Dr. Anton Hellman,
0:07.0	bringing you Canada's brightest minds in emergency medicine from EMC Studios in Toronto. Why is it that emergency doctors spend so little time talking about the things we so often see?
0:31.9	One of the most popular EM cases podcasts ever is the one we did with Andrew Morris, one of our distinguished guest today on UTI myths and misperceptions. Like UTI, skin and soft tissue infections are a dime
0:43.8	a dozen. And like UTI, they're misdiagnosed way more than we'd like to think. In fact,
0:50.1	cellulitis was misdiagnosed in the latest JAMA study 34% of the time.
0:57.1	Plus, with both UTI and skin and soft tissue infections, we sometimes don't choose antibiotics
1:02.7	very wisely.
1:04.6	Misdiagnosing UTI can sometimes be a pretty big deal, usually not catastrophic.
1:09.5	Misdiagnosing a soft tissue infection can also sometimes be a pretty big deal, even catastrophic
1:14.7	if you miss neck fash, for example.
1:17.7	So with the goal of sharpening your diagnostic skills when it comes to skin and soft tissue
1:22.0	infections, there are lots of cellulitis mimics out there that we're going to talk about,
1:26.5	and choosing wisely when it comes to treatment,
1:28.9	we'll be discussing best practices for management of cellulitis and skin abscesses,
1:33.8	when to cover for MRSA, how to pick up neck fash before it's too late, and a lot more.
1:39.5	And to help us along, it's my pleasure and honor to have back on the show,
1:43.7	Dr. Melanie Bamele,
1:45.1	EM doc from Sunnybrook Hospital. You might remember from our episodes on hyperk and hyponatremia,
1:51.3	and Dr. Andrew Morris, infectious disease doc and medical director of the antimicrobial
1:55.9	stewardship program at the Sinai Health System and University Health Network in Toronto.
2:01.6	Welcome, Andrew, and welcome Bell.
2:04.0	Happy to be here.
	...

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