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Likelihood Ratio (LR) in Emergency Medicine


Cellulitis and the role of laboratory

Clinical Scenario

A 72 y/o woman presented to the ED for swollen and painful leg.
Physical examination shows an erythematous, tender and warm leg. 
Probably it is a cellulitis. 
In previous post we stressed the US use to increase diagnostic accuracy. 

Can WBC or CPR help in the differential diagnoses?  
Do they have a role in the decision to admit the patient to the Hospital?  


WBC count is not helpful for differential diagnosis, or to determine the route of antibiotics administration, furthermore it has a small weight in the decision to admit a patient to the Hospital. 
An elevated CPR is a better indicator to “rule in” but if negative it’s unreliable. 

The routine blood investigation in ED takes another beating.


G.Phoenix et al
Diagnosis and management of cellulitis.
BMJ 2012 345: e4955 (published 7 Aug 2012).

Ciro Paolillo


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