severe Complicated Skin and Soft Tissue Infection

Severe Complicated Skin and Soft Tissue Infections: Causes, Symptoms, Risk Factors, and Treatment

Skin and soft tissue infections (SSTIs) are a common and costly cause of illness due to direct and indirect medical costs. Severe complicated SSTIs (cSSTIs) may cause significant damage to skin and underlying tissue, leading to impairments in function and quality of life. It is important to recognize the signs and symptoms, risk factors, and treatment approaches for cSSTI in order to improve outcomes and minimize unnecessary complications.

Causes of cSSTI

The most common causes of cSSTI are bacterial infections, particularly methicillin-resistant Staphylococcus aureus (MRSA). Other bacterial causes include streptococci, Pseudomonas aeruginosa, and Fusobacterium necrophorum. Viral causes are less common, but may include herpes simplex virus or the varicella-zoster virus. Fungal cSSTIs can occur in immunocompromised individuals.

Symptoms of cSSTI

Common symptoms of cSSTI include:

  • Pain and tenderness in the affected area
  • Redness and swelling
  • Drainage of pus, sometimes with an unpleasant smell
  • Fever and chills

Risk Factors for cSSTI

Risk factors for cSSTI include:

  • A weakened immune system due to chronic illness or medications
  • Trauma to the skin
  • Infection with resistant bacteria
  • Poor hygiene or living in a crowded or unclean environment
  • Diabetes
  • Malnutrition
  • Skin lesions
  • IV drug use

Treatment of cSSTI

Treatment of cSSTI may vary depending on the underlying cause. Antibiotics are frequently used to treat bacterial infections. Antifungal medications are used to treat fungal infections. Surgery may be necessary to remove necrotic tissue or to drain abscesses. Management of any underlying conditions, such as diabetes, may also be necessary.


Severe complicated skin and soft tissue infections can cause serious damage and impairments in function if not recognized and managed appropriately. It is important to recognize the signs and symptoms, underlying risk factors, and treatment options of cSSTI in order to improve outcomes and reduce potential complications.