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Most cutaneous abscesses require incision and drainage but not systemic antibiotics. By contrast, patients with cellulitis need systemic antibiotics, but incision and drainage are unnecessary and sometimes harmful. Distinguishing between these two disorders, therefore, is important, but how often do clinicians agree in their diagnoses of these conditions?
In this study from an emergency department in an urban, tertiary-care, pediatric hospital, 349 immunocompetent children with 394 lesions affecting the abdomen, legs, buttocks, or arms were evaluated for presence of an abscess and for the necessity for drainage. Each patient was independently examined by two physicians from a pool of 62 clinicians. The amount of agreement among the physician…