Tyler Luu, Rachel J Bystritsky
This article reviews the clinical presentation, diagnosis, microbiology, and management of non-purulent cellulitis. Cellulitis is primarily a clinical diagnosis, and unnecessary laboratory testing, imaging, and microbiologic cultures should be avoided in uncomplicated cases. Evidence suggests that β-hemolytic streptococci are the most common cause of non-purulent cellulitis, and empirical antimicrobial therapy should primarily target streptococci, with methicillin-resistant Staphylococcus aureus coverage reserved for selected patients with specific risk factors. The article also emphasizes the importance of diagnostic stewardship, appropriate antibiotic selection and other risk factors to reduce recurrence and improve patient outcomes.