A Predictive Model for Diagnosis of Lower Extremity Cellulitis

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In this cross-sectional study of 259 patients admitted through the emergency department between 2010 and 2012 with a diagnosis of lower extremity cellulitis, 30.5% were ultimately found to have been misdiagnosed with cellulitis. Variables associated with a true diagnosis of cellulitis included asymmetric involvement, leukocytosis, tachycardia, and an age >70. These variables were converted into a predictive model named the ALT-70 cellulitis score (asymmetry, 3 points; leukocytosis, 1 point; tachycardia, 1 point; age >70 years, 2 points). A score of 0–2 points indicates >83.3% likelihood of pseudocellulitis, and a score of >5 points indicates >82.2% likelihood of cellulitis.
A novel model incorporating the four variables of asymmetry, leukocytosis, tachycardia, and age >70 years is capable of predicting pseudocellulitis and cellulitis with a likelihood of >80%. This model may be useful in the emergency department for early identification and may reduce healthcare costs by precluding hospital admissions for pseudocellulitis.
– Jeffrey Scott, MD