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Hand cellulitis
From WikEM
Contents
Background
- Remove rings if infections are near the digits
Clinical Features
- Erythema, warmth, and edema
- Range of motion of digits, hand, and wrist should not be painful
- Pain predicts extensive involvement and the need for inpatient management
Differential Diagnosis
Hand and finger infections
- Bedbugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Evaluation
- Usually clinical
Management
- Mild/moderate cellulitis
- TMP-SMX DS 1-2 tab PO x 7-10d + (cephalexin 500mg PO QID x7-10d OR dicloxacillin 500mg PO QID x 7–10d)
- Severe cellulitis
- Vancomycin 1gm IV q12hr
Disposition
- Consider admission for:
- Immunocompromised
- Clinical toxicity
- Evidence of deep-space involvement
- Rapidly spreading infections
