This review evaluates the clinical presentation, diagnosis, microbiology, and management of non-purulent cellulitis, with emphasis on diagnostic stewardship, appropriate antibiotic selection, and strategies to reduce recurrence.
β-hemolytic streptococci are the most common cause of non-purulent cellulitis; empirical therapy should target streptococci, with MRSA coverage reserved only for patients with specific risk factors. Routine labs, imaging, and cultures are discouraged in uncomplicated cases.
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For uncomplicated non-purulent cellulitis, skip routine labs, imaging, and cultures — empirical anti-streptococcal therapy is the right first move. Add MRSA coverage only when clear risk factors are present.
