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. 2019 Jan 16;15(4):995–1002. doi: 10.1080/21645515.2018.1553474

Table 3.

Brighton collaboration case definitions of cellulitis and infectious abscess.

Cellulitis1 Infectious abscess2
Level 1a of diagnostic certainty
At least three of the following four signs/symptoms:

  • Localised pain or tenderness (pain to touch);

  • Erythema;

  • Induration or swelling;

  • Warmth;


AND

  • Reaction is at the injection site; AND

  • Laboratory-confirmation by culture.


If known, exclusion criteria are:

  • Spontaneous rapid resolution; AND/OR

  • Fluctuance.


Level 1b of diagnostic certainty

  • A diagnosis of cellulitis by a qualified health care provider; THAT IS

  • At the injection site; AND

  • Laboratory-confirmation by culture.


If known, exclusion criteria are:

  • Spontaneous rapid resolution; AND/OR

  • Fluctuance.

 Level 1 of diagnostic certainty

  • Spontaneous or surgical drainage of material from the mass;


AND

  • Laboratory confirmation (Gram stain, culture or other tests) of microbiological organisms with or without polymorphonuclear leukocytes in material drained or aspirated from mass.
Level 2 of diagnostic certainty
At least three of the following four signs/symptoms:

  • Localised pain or tenderness (pain to touch);

  • Erythema;

  • Induration or swelling;

  • Warmth;


AND

  • Reaction is at the injection site; AND

  • Has been diagnosed by a qualified health care provider.

 Level 2 of diagnostic certainty

  • Spontaneous or surgical drainage of purulent material from the mass;


OR

  • Collection of material diagnosed by an imaging technique (e.g., sonogram, CT, MRI, or other modality) or fluctuance;AND

  • Localized sign(s) of inflammation including at least one of the following: erythema, pain to light touch, or warm to touch at the injection site;


AND

  • Resolution/improvement temporally related to antimicrobial therapy


Abscesses of infectious etiology may be accompanied by fever and/or regional lymphadenopathy.

1Halperin S, Kohl KS, Gidudu J, et al. Cellulitis at injection site: Case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2007;25:5803–5820.

2Kohl KS, Ball L, Gidudu J, et al. Abscess at injection site: Case definition and guidelines for collection, analysis and presentation of immunization safety data. Vaccine. 2007;25:5821–5838.