Lower Extremity Cellulitis Largely Misdiagnosed, Study Finds

Misdiagnosis leads to 50,000 to 130,000 unnecessary hospitalizations, costs of $195 to $515 million
Misdiagnosis leads to 50,000 to 130,000 unnecessary hospitalizations, costs of $195 to $515 million

HealthDay News — More than 30% of patients admitted with a diagnosis of lower extremity cellulitis are misdiagnosed, according to a study published online November 2 in JAMA Dermatology.

Qing Yu Weng, MD, from Massachusetts General Hospital in Boston, and colleagues conducted a cross-sectional study involving patients admitted from the emergency department of a large urban hospital with a diagnosis of lower extremity cellulitis. Patients who were discharged with a cellulitis diagnosis were characterized as having cellulitis, while those given an alternative diagnosis were considered to have pseudocellulitis. The authors calculated hospitalization costs per year attributed to misdiagnosed lower extremity pseudocellulitis. 

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The researchers found that 30.5% of 259 patients were misdiagnosed with cellulitis, and 52 of these 79 misdiagnosed patients were primarily admitted for cellulitis treatment. Of the 52 patients, 84.6% did not require hospitalization based on ultimate diagnosis and 92.3% received antibiotics unnecessarily. Cellulitis misdiagnosis was estimated to lead to 50,000 to 130,000 unnecessary hospitalizations, and avoidable health care spending of $195 million to $515 million. Per year, unnecessary antibiotics and hospitalizations for misdiagnosed cellulitis were estimated to cause >9,000 nosocomial infections, 1,000 to 5,000 Clostridium difficile infections, and two to six cases of anaphylaxis.

"Misdiagnosis of lower extremity cellulitis is common and may lead to unnecessary patient morbidity and considerable health care spending," the authors write.

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