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In the Clinic |

Cellulitis and Soft-Tissue Infections

Lawrence J. Eron, MD
Ann Intern Med. 2009;150(1):ITC1-1. doi:10.7326/0003-4819-150-1-200901060-01001
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Cellulitis is an infection of the skin and underlying tissues. It may follow a break in the skin or a surgical wound but may also occur without an obvious inciting event. The microorganisms most frequently involved include group A streptococci (Streptococcus pyogenes); groups B, C, and G β-hemolytic streptococci; and Staphylococcus aureus. Over recent decades, cellulitis has challenged clinicians in several ways. First, physician visits for cellulitis and soft-tissue infections have increased from 32 to 48 visits per 1000 population from 1997 to 2005 (1). Second, necrotizing fasciitis due to group A streptococci is now endemic in the United States. Third, S. aureus, the predominant cause of cellulitis accompanied by abscesses or wound drainage, has become increasingly resistant to methicillin, requiring vancomycin and other, newer antimicrobial agents. A particular community-acquired methicillin-resistant S. aureus (CA-MRSA) strain, USA 300, is replacing nosocomial strains of MRSA in hospitals (2).

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