The effect of histopathologic analysis and tissue cultures on inpatient management of cellulitis: a randomized control trial

The Effect of Histopathologic Analysis and Tissue Cultures on Cellulitis Management

Background

In cases of cellulitis, it can be challenging to accurately diagnose due to the lack of a definitive diagnostic method, leading to potential misdiagnosis of other inflammatory disorders as cellulitis.

Objective

This study aimed to assess the usefulness of skin biopsy and tissue culture in diagnosing and managing patients admitted with a presumed diagnosis of cellulitis.

Design

A pilot single-blind parallel group randomized controlled clinical trial involving 56 patients with a primary diagnosis of presumed cellulitis. The intervention group had access to skin biopsy and tissue culture results to guide diagnosis and management, while the control group did not. The length of hospital stay and antibiotic use were evaluated as outcome measures.

Results

The study found that the length of hospital stay showed potential for further investigation as a primary outcome, with the intervention group having a median stay of 4 days (range 2-6) compared to 5 days (range 3-8) in the control group (p = 0.124).

Limitations

The COVID-19 pandemic limited participant enrollment and study duration, and data was collected from a single medical center.

Conclusion

The study suggests that skin biopsy and tissue culture results may impact the length of hospital stay and the de-escalation of anti-pseudomonal antibiotics in patients with presumed cellulitis, indicating the need for further investigation into these outcomes.

PMID: 39042316 | DOI: 10.1007/s00403-024-03224-5

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