Complicated Skin and Soft Tissue Infection
A complicated skin and soft tissue infection extends beyond a minor superficial infection or occurs where depth, anatomy or health factors raise failure risk.
Key takeaways
- Abscess, dead tissue, foreign material, poor circulation and diabetes can make source control essential.
- Antibiotic choice depends on purulence, exposure, likely organisms, severity and local resistance rather than “broadest is best.”
- Pain out of proportion, rapid spread, skin discolouration or systemic toxicity raises concern for necrotising infection.
The listings below do not establish depth or organisms; complicated infection needs urgent clinical and sometimes surgical assessment.
Defining the extent
Examination looks for fluctuance, crepitus, blistering, impaired perfusion and spread along a limb. Ultrasound can identify an abscess, while CT or MRI may assess deep collections or fascia. Cultures from pus or tissue are more useful than a superficial swab.
Treatment priorities
Drainage, debridement and removal of infected devices may be decisive. Empirical systemic antibiotics cover likely organisms and are narrowed when results permit. Blood-sugar control, wound care and restoration of circulation support recovery; antibiotics cannot rescue dead tissue by themselves.
When to seek urgent care
Seek emergency care for rapidly spreading redness or swelling, severe pain out of proportion, purple or black skin, blisters, gas in tissue, confusion, fainting or high fever with shaking chills.