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Comment & Response
August 2018

The Hindsight Problem in Evaluating the Value of Ultrasonography in Cellulitis

Author Affiliations
  • 1Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Lown Institute, Brookline, Massachusetts
  • 3Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York
JAMA Intern Med. 2018;178(8):1141. doi:10.1001/jamainternmed.2018.3248

To the Editor We commend Ko et al for their article,1 and we wholeheartedly agree that there is overuse of both imaging and blood cultures in cellulitis. In regard to ultrasonography in cellulitis, the driver of overtesting may not be concern for complications (eg, abscess) but rather in ascertaining the correct initial diagnoses. As the authors stated, the Infectious Diseases Society of America does not recommend routine imaging for cellulitis except in patients with febrile neutropenia.2 However, the possibility of a deep venous thrombosis (DVT), either as an alternate or concurrent diagnosis, is concerning for many front-line clinicians.

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