Usefulness of Serum Procalcitonin for Early Discrimination Between Necrotizing Fasciitis and Cellulitis

Kato, Takeshi; Fujimoto, Noriki; Honda, Shin‐ichiro; Fujii, Norikazu; Shirai, Masae; Nakanishi, Takeshi; Nakanishi, Gen; Tanaka, Toshihiro

doi:10.2340/00015555-2465

Cited by 16 publications

(15 citation statements)

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“…). A total of 98 papers were included for full‐text screening . Of these, 90 papers were subsequently excluded, including 20 studies that did not specify the site of cellulitis…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 90 papers were subsequently excluded, including 20 studies that did not specify the site of cellulitis and eight studies that did not separate the results of lower‐limb cellulitis from other sites . Eight studies were included for data extraction …”

Section: Resultsmentioning

confidence: 99%

“…explored lower‐limb cellulitis as the main pathology . Seven studies included patients with lower‐limb cellulitis as a comparison group, in which cellulitis and other diagnoses were compared …”

Section: Resultsmentioning

confidence: 99%

“…Six studies were case–control studies, one study was a cohort study and there was one cross‐sectional study . The most common setting was the ED (three studies) .…”

Section: Resultsmentioning

confidence: 99%

“…The reference test for cellulitis was a clinical diagnosis in seven studies, with a bone scan used by Fleischer et al . However, only Rabuka et al .…”

Section: Resultsmentioning

confidence: 99%

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A systematic review showing the lack of diagnostic criteria and tools developed for lower‐limb cellulitis

et al. 2019

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SummaryBackgroundCellulitis can be a difficult diagnosis to make. Furthermore, 31% of patients admitted from the emergency department with suspected lower‐limb cellulitis have been misdiagnosed, with incorrect treatment potentially resulting in avoidable hospital admission and the prescription of unnecessary antibiotics.ObjectivesWe sought to identify diagnostic criteria or tools that have been developed for lower‐limb cellulitis.MethodsWe conducted a systematic review using Ovid MEDLINE and Embase databases in May 2018, with the aim of describing diagnostic criteria and tools developed for lower‐limb cellulitis, and we assessed the quality of the studies identified using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. We included all types of study that described diagnostic criteria or tools.ResultsEight observational studies were included. Five studies examined biochemical markers, two studies assessed imaging and one study developed a diagnostic decision model. All eight studies were considered to have a high risk for bias in at least one domain. The quantity and quality of available data was low and results could not be pooled owing to the heterogeneity of the findings.ConclusionsThere is a lack of high‐quality publications describing criteria or tools for diagnosing lower‐limb cellulitis. Future studies using prospective designs, validated in both primary and secondary care settings, are needed. What's already known about this topic? Diagnosing lower‐limb cellulitis on first presentation is challenging.Approximately one in three patients admitted from the emergency department with suspected lower‐limb cellulitis do not have cellulitis and are given another diagnosis on discharge. Consequently, this results in potentially avoidable hospital admissions and the prescription of unnecessary antibiotics.There are no diagnostic criteria available for lower‐limb cellulitis in the U.K. What does this study add? This systematic review has identified a key research gap in the diagnosis of lower‐limb cellulitis.There is a current lack of robustly developed and validated diagnostic criteria or tools for use in clinical practice.

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“…). A total of 98 papers were included for full‐text screening . Of these, 90 papers were subsequently excluded, including 20 studies that did not specify the site of cellulitis…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Six studies were case–control studies, one study was a cohort study and there was one cross‐sectional study . The most common setting was the ED (three studies) .…”

Section: Resultsmentioning

confidence: 99%

“…The reference test for cellulitis was a clinical diagnosis in seven studies, with a bone scan used by Fleischer et al . However, only Rabuka et al .…”

Section: Resultsmentioning

confidence: 99%

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