ABSTRACT
Skin and soft tissue infections are common and vary widely in severity from minor pyodermas to severe necrotizing infections. Most of these infections are superficial and treated with regimens of local care and antimicrobial therapy. However, others like necrotizing infections are life threatening and require a combined medical and surgical intervention. Prompt recognition and treatment is paramount in limiting the morbidity and mortality associated with these infections, and thus a thorough understanding of the various etiologies and presentation is essential in the critical care setting. It is also important to discriminate between infectious and noninfectious causes of skin and soft tissue inflammation. A detailed history and examination are necessary to narrow the possible etiologies of infection. In many instances surface cultures are unreliable and misleading because surface colonizing organisms can be mistaken for pathogens. In instances in which the diagnosis is in doubt, aspiration, biopsy, or surgical exploration of the skin can be considered. Here we review causes of severe skin and soft tissue infection, highlighting the clinical presentation, diagnosis, and approach to management in the critical care setting.
