Diagnosis and management of skin and soft tissue infections in the intensive care unit: a review

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26 Scopus citations

Abstract

Purpose: To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. Methods: Guidelines, expert opinion, and local institutional policies were reviewed. Results: Severe SSTIs are common and their management complex due to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses. Unique aspects of care for SSTIs in the ICU are discussed, including the role of prosthetic devices, risk factors for bacteremia, and the need for surgical consultation. SSTI mimetics, the role of dermatologic consultation, and the unique features of SSTIs in immunocompromised hosts are also described. Conclusions: We provide recommendations for clinicians regarding optimal SSTI management in the ICU setting.

Original languageEnglish
Pages (from-to)1899-1911
Number of pages13
JournalIntensive care medicine
Volume42
Issue number12
DOIs
StatePublished - Dec 1 2016

Keywords

  • Gas gangrene
  • Necrotizing fasciitis
  • Skin and soft tissue infections in the intensive care unit

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