Use of cultures in cellulitis: when, how, and why?

Abstract

Correct management of patients with cellulitis poses both diagnostic and therapeutic challenges. Unless a wound is present, obtaining a specimen for culture to determine the causative organism may be difficult. Thus, initial therapy of cellulitis is usually empirical and based on clinical presentation, epidemiological clues, and statistical probabilities. In most cases, initial antimicrobial therapy targets the two most common etiologic agents – beta-hemolytic streptococci and Staphylococcus aureus [1]. Resistant organisms may occasionally be present, however, and unless they are identified, the prescribed antimicrobial therapy may be inadequate. An incorrect choice of initial treatment of cellulitis may delay discharge from the hospital and potentially increase morbidity and mortality. What type of culture to obtain?