Episode 910: Cellulitis Recovery Timeline

Emergency Medical Minute

Contributor: Aaron Lessen, MD

Educational Pearls:

How fast does cellulitis recover?

• A recent prospective cohort study took a look at this question.

• The study included 300 adults with cellulitis (excluding those with peri-orbital cellulitis or abscesses) in two emergency departments in Queensland, Australia.

• They collected data from initial and follow-up surveys at 3, 7, and 14 days, and compared clinician and patient assessments at day 14.

• Improvement was fastest between day 0 and day 3, with gradual progress thereafter.

• At day 14, many still had skin redness and swelling, though warmth had often resolved. Clinicians reported higher cure rates than patients (85.8% vs. 52.8%).

• Conclusion:

• Cellulitis symptoms improve quickly at first but continue to linger for many patients.

• Patients and doctors often have different views on when cellulitis is fully cured.

How should we counsel patients?

• Even on antibiotics, the margins of the cellulitis may continue to spread a small amount.

• Skin warmth should be the first symptom to go away.

• It takes time to get better. Only about 50% of patients believed their cellulitis was cured at 2 weeks.

References

1. Nightingale, R. S., Etheridge, N., Sweeny, A. L., Smyth, G., Dace, W., Pellatt, R. A. F., Snelling, P. J., Yadav, K., & Keijzers, G. (2024). Cellulitis in the Emergency Department: A prospective cohort study with patient-centred follow-up. Emergency medicine Australasia : EMA, 10.1111/1742-6723.14401. Advance online publication. https://doi.org/10.1111/1742-6723.14401

Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSIII