Surgical exploration and debridement is both the definitive diagnostic modality and the definitive treatment
Indicated in setting of severe pain, toxicity, fever, elevated CK (with or without radiographic evidence)
Antibiotics
Must cover gram positives, gram negatives, and anaerobes (especially GAS and clostridium)
Piperacillin-Tazobactam 3.375-4.5g q6hr AND clindamycin 600-900mg q8hr AND vancomycin 1gm IV q12hr (consider weight base dosing of 20 mg/kg)
Piperacillin-Tazobactam 3.375-4.5g q6hr and linezolid 600mg q12hr is an alternative regimen
In diabetics, maintain strict glycemic control (with IVFs and IV insulin if necessary)
Indicated in setting of severe pain, toxicity, fever, elevated CK (with or without radiographic evidence)
Must cover gram positives, gram negatives, and anaerobes (especially GAS and clostridium)
Piperacillin-Tazobactam 3.375-4.5g q6hr AND clindamycin 600-900mg q8hr AND vancomycin 1gm IV q12hr (consider weight base dosing of 20 mg/kg)
Piperacillin-Tazobactam 3.375-4.5g q6hr and linezolid 600mg q12hr is an alternative regimen
Necrotizing fasciitis
Cellulitis
Necrotizing cellulitis
Hand cellulitis
Wet gangrene
Facial cellulitis
Plantar fasciitis
Orbital cellulitis