Severe Skin and Soft Tissue Infections
Severe skin and soft-tissue infection extends beyond a minor surface infection, progresses rapidly, involves deep structures or causes systemic illness. Necrotising infection is a surgical emergency.
Key takeaways
- Rapid spread, severe pain beyond visible changes, blisters, dusky skin, numbness, crepitus or systemic illness are high-risk findings.
- Examination, imaging, cultures and surgery may be needed, but testing should not delay urgent exploration when necrotising infection is suspected.
- Antibiotics alone cannot drain an abscess or remove dead tissue; source control can be as important as antimicrobial coverage.
Catalogue matches are not emergency treatment and do not identify the bacteria, drug combination, route or surgical need.
Which features suggest deep infection?
Pain out of proportion, rapidly advancing swelling, skin discolouration and declining sensation suggest deeper damage. Diabetes, immune suppression, vascular disease, recent surgery and contaminated injuries can increase complication risk.
How is treatment selected?
Urgent care may combine broad initial antibiotics with drainage or debridement, then narrow treatment using findings and cultures. Clindamycin has selected roles but is not universal MRSA or anaerobic coverage and carries important adverse effects.
When to seek urgent care
Call emergency services for rapidly spreading redness or swelling with severe pain, blisters, dark skin, numbness, confusion, fainting or marked systemic illness.