31st May 2024

Diagnosis and Management

Most infections are caused by the above gram-positive organisms, though diabetics and those with peripheral vascular disease may also develop gram-negative infections such as pseudomonas. Diagnosis is clinical, based on the appearance and spread of erythema. Pain tends to be localised and patients can be systemically unwell in more severe cases.

Infection can occur due to breaks in the skin acting as a portal of entry, or occasionally, haematogenous spread can seed to the skin.

Management involves IV or oral Flucloxacillin as a first line, with Clindamycin often used as the second line. Vancomycin, Teicoplanin and metronidazole can also be used, the latter for anaerobic infections.