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Walker TD, Gilkey TW, Trinidad JC, Chung CG, Wang H, Mostaghimi A, Kaffenberger BH. Evaluation of Dundee and ALT-70 predictive models for cellulitis in 56 patients who underwent tissue culture. Arch Dermatol Res 2023; 315:665-668. [PMID: 36273340 DOI: 10.1007/s00403-022-02409-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 09/22/2022] [Accepted: 10/13/2022] [Indexed: 11/02/2022]
Abstract
Nonpurulent cellulitis lacks a gold standard to distinguish noninfectious sources of inflammation. Two models have been created that evaluate cellulitis. The ALT-70 model was created to reduce the overdiagnosis of cellulitis and provide clinical direction. The Dundee classification was developed to grade the severity of previously diagnosed cases of cellulitis and enhance treatment and clinical outcomes. We analyzed a dataset of 56 patients who were admitted to the OSU Wexner Medical Center with a primary admission diagnosis of cellulitis. Each patient underwent extensive tissue culture sampling to identify potential pathogens. Patients were scored using both models, then evaluated based on the positive tissue culture and skin and soft tissue infection. In both models, we found low sensitivity and specificity to predict patients with positive tissue culture cellulitis. Determination of a gold standard for classification of cellulites is important to improve future diagnosis and risk models. We recommend further study to develop a scalable consensus standard in the diagnosis of nonpurulent cellulitis.
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Affiliation(s)
- Trent D Walker
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Ty W Gilkey
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - John Christopher Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Catherine G Chung
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
- Department of Pathology and Laboratory Medicine, The Ohio State University, Columbus, OH, USA
| | - Henry Wang
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
- , 1328 Dublin Road, Suite 100, Columbus, OH, 43212, USA.
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