Cellulitis Often Misdiagnosed in ED — Physician’s First Watch

Medical News |
November 3, 2016

Cellulitis Often Misdiagnosed in ED

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM

Cellulitis is often misdiagnosed in the emergency department, leading to unnecessary healthcare spending, suggests a JAMA Dermatology study.

Of roughly 250 adults admitted through an ED with presumed cellulitis of the lower extremities, 31% were ultimately given a different diagnosis within 30 days of discharge. The most common misdiagnoses were vascular or inflammatory conditions. Roughly two-thirds of the misdiagnosed patients were admitted primarily for cellulitis. All of these misdiagnosed patients received at least one IV antibiotic. Further review indicated that, had these patients been correctly diagnosed, 85% would not have required admission.

Using national data from 2010, the authors estimate that 18,000–48,000 patients admitted each year through EDs with suspected lower extremity cellulitis are misdiagnosed, at a cost of $195–$515 million, not including the cost of unnecessary antibiotics and complications.

The authors conclude: "Our study serves as a call to arms for improving the care of patients with suspected lower extremity cellulitis ... It has been previously shown that dermatology consultation in the inpatient setting may be helpful in increasing diagnostic accuracy, and we are presently in the process of developing a predictive model for the assessment of possible cellulitis."

Reader Comments (1)

PETER J WALDMAN, CO Physician, Emergency Medicine, United States

Great conclusion! Ever try to get a dermatologist for an emergency consult in the ED? Good grief.

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.