Complicated and deep bacterial skin and soft tissue infections

Complicated erysipelas, cellulitis, and necrotizing soft tissue infections belongto the spectrum of bacterial infections affecting the skin and underlying softtissues. Their frequency as well as risk of recurrence and complicated diseasecourse pose a significant health burden. The latter is further impacted by global travel activity, associated variations in the prevalence of microbes, the emer-gence of multi-resistant bacteria, demographically driven aging with increaseof critical comorbidities, immunosuppressive therapies as well as excessive (alsonon-medical) use of antibiotics.Against this background, early and accurate diagnosis and immediately promptedtherapeutic measures are major determinants of prognosis and clinical outcome.Diagnostic evaluation involves clinical, laboratory, microbiological and radiogra-phic findings which are assessed in the context of patient-specific risk factorsand comorbidities. First and foremost, given the indication, exploratory incisionsof lesional tissue should be obtained which allow to instantaneously assess theextent of tissue necrosis and provide guidance on the scope and extent of further(surgical and non-surgical) treatment modalities. Thereby, delayed or inadequateinterventions are avoided which reduces duration of treatment, health expenses,the risk of recurrent hospitalizations, as well as mortality rates.