CCS: cellulitis in leg - mattlee

[ArchivalUser]

UW states that pt should be put on IV fluid, normal celine. in their Approach, they did not order regular diet. pt stayed in the hospital for 2 days. i am just wondering why the patient with leg cellulitis can not have regular diet. they only receive normal celine for 2 days. isn't that a problem?

[ArchivalUser]

ok, i found that actually they did let order reguar diet. but the question is since they can eat their regular diet, why should we still give them normal celine?

[ArchivalUser]

what is the BP?

[ArchivalUser]

BP was fine.

also the blood culture was negative. they continued to give IV antibiotics, when discharge, they continue to give pt oral antibiotics. just wonder why?

[ArchivalUser]

cellulitis........sepsis.............septic shock............NS iv

[ArchivalUser]

blood culture negative doesnt mean you dont treat cellulitis WHICH IS CLINICAL DIAGNOSIS

ANY INFECTIONS START EMPIRICAL ANTIBIOTIC IV AND AT THE TIME OF DISCHARGE ORAL

[ArchivalUser]

but blood culture x3 were all negative

[ArchivalUser]

again cellultitis is clinical diagnosis.

[ArchivalUser]

I wanted to answer the poster's question from 8/22/9 12:34. In UWorld Case 27, a 40-year old previously health man presents with leg cellulitis. His temperature is 39.5 C (103.1 F), he is tachycardic (HR 110) with BP 110/64. The patient denies nausea/vomiting in the "Initial History." There are no signs of dehydration on physical examination & his mucous membranes are moist. Serum sodium within the first hour of presentation is 139 mEq/L. UWorld's "Clock Management" for the case starts him on BOTH IV NSS 0.9% and normal diet when he is admitted.

Although I could not find a specific U.S. guideline for the use of IV fluids in cellulitis, I believe that ordering BOTH NSS and normal diet is not indicated in this case. See, e.g., http://medicine.ucsf.edu/education/resed...ts/ivf.pdf, which suggests that IV fluids should only be started in euvolemic patients if they are NPO or are likely to be NPO.

Thank you!

[ArchivalUser]

I think , it depends how bad the cellulitis is ; some time if it is very bad ,you start the iv abx and nss for prepartion of debridement which can be done under anesthesia, so it might be a preparation for the surgical procedure, generally these cellulitis pt are DM pt and the cellulitis are so bad and they continously come for debridement, I am just guessing.