Cellulitis referral checklist

Urgency tier

• Immediate emergency transfer for systemic instability, severe pain out of proportion or necrotizing-infection concern; do not await outpatient referral or investigations.
• Expedited referral for recurrent cellulitis or inadequate response to initial management.
• Routine referral for non-urgent recurrence prevention planning.

Minimum pre-referral workup

• Defined infection timeline, exam findings, and progression documentation.
• Host-risk review (diabetes, vascular disease, immunocompromise).
• Initial treatment used, adherence, and response over 24-48 hours.

Referral packet checklist

• Infection site details, severity trend, and border progression notes.
• Baseline labs/imaging where performed and current treatment details.
• Relevant comorbid conditions and medication list.

Pre-referral optimization tasks

• Continue wound-care and hydration instructions.
• Reinforce return precautions for fever, spread, or systemic decline.
• Arrange short-interval interim follow-up while awaiting referral.

References

• IDSA Skin and soft tissue infection guideline (2014) (opens in a new tab)
• CDC Clinical guidance for group A streptococcal cellulitis (2025) (opens in a new tab)
• NICE NG141 Cellulitis and erysipelas recommendations (opens in a new tab)

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