Emergency Medical Minute2 Jul 2024

Episode 910: Cellulitis Recovery Timeline

Contributor: Aaron Lessen, MD

Educational Pearls:

How fast does cellulitis recover?

A recent prospective cohort study took a look at this question.

The study included 300 adults with cellulitis (excluding those with peri-orbital cellulitis or abscesses) in two emergency departments in Queensland, Australia.
They collected data from initial and follow-up surveys at 3, 7, and 14 days, and compared clinician and patient assessments at day 14.
Improvement was fastest between day 0 and day 3, with gradual progress thereafter.
At day 14, many still had skin redness and swelling, though warmth had often resolved. Clinicians reported higher cure rates than patients (85.8% vs. 52.8%).
Conclusion:

Cellulitis symptoms improve quickly at first but continue to linger for many patients.
Patients and doctors often have different views on when cellulitis is fully cured.

How should we counsel patients?

Even on antibiotics, the margins of the cellulitis may continue to spread a small amount.
Skin warmth should be the first symptom to go away.
It takes time to get better. Only about 50% of patients believed their cellulitis was cured at 2 weeks.

References

Nightingale, R. S., Etheridge, N., Sweeny, A. L., Smyth, G., Dace, W., Pellatt, R. A. F., Snelling, P. J., Yadav, K., & Keijzers, G. (2024). Cellulitis in the Emergency Department: A prospective cohort study with patient-centred follow-up. Emergency medicine Australasia : EMA, 10.1111/1742-6723.14401. Advance online publication. https://doi.org/10.1111/1742-6723.14401

Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSIII

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