MBBS OSCE · General Medicine
OSCE — Cellulitis & Skin / Soft-Tissue Infection
Eight-minute OSCE station on Cellulitis & Skin / Soft-Tissue Infection: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Cellulitis & Skin / Soft-Tissue Infection.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Cellulitis is an acute, spreading, non-suppurative infection of the dermis and subcutaneous tissue, usually caused by Streptococcus pyogenes or Staphylococcus aureus (including community-acquired MRSA), presenting with erythema, warmth, swelling and tenderness with poorly demarcated margins, usually on a leg and often through a portal of entry (tinea pedis, ulcer, trauma, IV site). Erysipelas is the superficial variant with raised, sharply demarcated margins. Necrotising fasciitis is the life-threatening deep-fascial variant — severe pain out of proportion, systemic toxicity, skin necrosis or bruising, bullae, crepitus, rapid spread — needing urgent surgical debridement. Management is driven
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Severe pain out of proportion to skin findings with systemic toxicity, bruising, |
| Safety | Rapidly spreading cellulitis with fever, tachycardia, hypotension or confusion - |
| Safety | Purulent cellulitis or abscess with MRSA risk - incision and drainage; add MRSA |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.