Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
College of Medicine, The Ohio State University, Columbus, OH, USA.
Arch Dermatol Res. 2024 Jul 23;316(7):482. doi: 10.1007/s00403-024-03224-5.
In the absence of a gold-standard diagnostic modality for cellulitis, sterile inflammatory disorders may be misdiagnosed as cellulitis.
To determine the utility of skin biopsy and tissue culture for the diagnosis and management of patients admitted with a diagnosis of presumed cellulitis.
Pilot single-blind parallel group randomized controlled clinical trial in 56 patients with a primary diagnosis of presumed cellulitis. In the intervention group only, skin biopsy and tissue culture results were made available to the primary care team to guide diagnosis and management. Length of hospital stay and antibiotic use were evaluated as outcome measures.
Length of stay showed the greatest opportunity for further study as a primary outcome (intervention: 4, IQR (2-6) vs. control: 5 IQR (3-8) days; p = 0.124).
The COVID-19 pandemic placed limitations on participant enrollment and study duration; in addition, data was collected from a single medical center.
This study demonstrates that length of stay and anti-pseudomonal antibiotic de-escalation are endpoints that may be influenced by biopsy and tissue culture results in presumed cellulitis patients; these outcomes warrant further study.
由于缺乏金标准的蜂窝织炎诊断方式，无菌性炎症性疾病可能被误诊为蜂窝织炎。
确定皮肤活检和组织培养在诊断和管理以疑似蜂窝织炎为诊断的患者中的作用。
56 名疑似蜂窝织炎患者的单盲平行组随机对照临床试验。仅在干预组中，将皮肤活检和组织培养结果提供给初级保健团队，以指导诊断和管理。将住院时间和抗生素使用作为评估的结果指标。
住院时间是作为主要结局指标最有研究价值的一项（干预组：4，IQR（2-6）vs. 对照组：5，IQR（3-8）天；p=0.124）。
COVID-19 大流行限制了参与者的招募和研究时间；此外，数据是从一家医疗中心收集的。
本研究表明，在疑似蜂窝织炎患者中，活检和组织培养结果可能会影响住院时间和抗假单胞菌抗生素降阶梯治疗，这些结果值得进一步研究。
