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Cellulitis — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlCellulitisSCE Infectious Diseases

A 30-year-old man develops an erythematous, well-demarcated, tender plaque on his right lower leg after a minor laceration while gardening. There is no fluctuance. He is systemically well with a temperature of 37.8°C. What is the most likely diagnosis and first-line treatment?

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Correct answer: A — Cellulitis; Flucloxacillin 500 mg QDS for 5 days

An erythematous, tender, non-fluctuant plaque on the lower limb following skin breach is consistent with cellulitis. NICE NG141 recommends Flucloxacillin 500 mg QDS for 5 days as first-line for non-severe cellulitis (covering S. aureus and streptococci). Erysipelas (more superficial, sharply demarcated raised border, typically streptococcal) may be treated with Phenoxymethylpenicillin, but the clinical distinction from cellulitis is often difficult. Mark the border of erythema to monitor progression. Elevation of the affected limb is also recommended.

Reference: NICE NG141 2019 – Cellulitis and erysipelas; CREST 2005 – Cellulitis guidelines