From the Guidelines
Physical exam findings suggestive of cellulitis include erythema, warmth, swelling, and tenderness of the affected skin area, with poorly defined borders that may expand over time, as well as pain, shiny or taut skin due to edema, and potential systemic signs such as fever, chills, and malaise 1. These findings are crucial for diagnosing cellulitis, a common bacterial skin infection.
- Key physical exam findings include:
- Erythema (redness)
- Warmth
- Swelling
- Tenderness
- Poorly defined borders
- Pain
- Shiny or taut skin due to edema
- Systemic signs may include:
- Fever
- Chills
- Malaise
- It is essential to monitor the progression or improvement of cellulitis by marking the borders of erythema and checking for fluctuance, which may indicate abscess formation 1.
- Cellulitis can occur anywhere on the body, but it most commonly affects the lower extremities, and identifying potential entry points like wounds, ulcers, or dermatitis can help determine the cause 1.
- The presence of crepitus on palpation raises concern for necrotizing fasciitis or gas gangrene, which are surgical emergencies 1.
From the Research
Physical Exam Findings for Cellulitis
The physical exam findings that suggest cellulitis include:
Clinical Presentation
Cellulitis typically presents with an acute onset of these symptoms, making it a clinical diagnosis based on history and physical examination 2, 3, 4, 5. However, it can be difficult to diagnose due to various infectious and non-infectious clinical mimickers such as venous stasis dermatitis, contact dermatitis, eczema, lymphedema, and erythema migrans 3, 5, 6.
Diagnostic Challenges
Microbiological diagnosis is often unobtainable due to poor sensitivity of culture specimens 5, and there are no effective diagnostic modalities, making the diagnosis of cellulitis primarily based on history and physical examination 2.