Introduction
What is cellulitis?:
Cellulitis is a serious skin infection that happens when bacteria enter the deeper layers of skin. It causes the skin to become red, swollen, warm and painful. The infection does not have clear edges and can spread quickly if not treated.Who gets it?- It can happen to anyone but it is more common in 1) young children and infants 2) Elderly people 3) People with weak immune systems , such as those with Diabetes. The most common organisms implicated in cellulitis are Staphylococcus aureus, Streptococcus pyogenes, Hemophilus influenza type b, Prevotella spp, B fragilis group, and Clostridium species3,4. However, infection is usually polymicrobial which also includes anaerobic bacteria, and isolation of a single organism is often not possible2. Hib is the most common cause of periorbital and orbital cellulitis4.
What does it look like?
Children with cellulitis may have:
- A red, swollen, warm, and painful area of skin
- Fever, chills, or feeling unwell
- Blisters or pus in the infected area
- Swollen glands near the infection
The infection usually affects the arms, legs, face, fingers, or toes. In children, cellulitis around the eyes (periorbital/orbital cellulitis) is common and often linked to sinus infections.
Diagnosis
The diagnosis is mostly clinical and sometimes the local wound cultures or blood cultures can help to identify the causative organism. The patient also has elevated WBC count.
Doctors ma also perform a blood test or swab the area to find out what bacteria is causing the infection
Check for signs the infection is spreading , especially if the child has a fever or appears very ill.
Treatment
- Mild cases can often be treated at home with oral antibiotics (liquid or pills).
- Severe cases may need hospital care and IV antibiotics.
Most children get better within 7 to 10 days. It’s important to complete the full course of antibiotics even if your child starts feeling better early.
Other things that help:
- Elevate the affected arm or leg to reduce swelling
- Use cool compresses and pain relievers like acetaminophen or ibuprofen (as per doctor’s advice)
If the infection doesn’t improve or worsens, the doctor may change the antibiotics or suggest other treatments. Rarely, surgery is needed to drain an abscess or remove infected tissue.
1. Ann Van den Bruel, Bert Aertgeerts, Rudi Bruyninckx, Marc Aerts and Frank Buntinx .Signs and symptoms for diagnosisof serious infections in children:a prospective study in primary care. British Journal of General Practice 2007; 57: 538-546.
2. Stulberg DL, Penrod MA, Blatny RA. Common bacterial skin infections. Am Fam Physician. 2002 Jul 1;66(1):119-24. Review.
3. Itzhak Brook. Aerobic and anaerobic microbiology of infections after trauma in children. J Accid Emerg Med 998;15:162-167.
4. Ambati BK, Ambati J, Azar N, Stratton L, SchmidtEV. Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination. Ophthalmology 2000;107:1450-3.
5. Rasi A, Pour-Heidari N Association between Plaque-Type Psoriasis and Perianal Streptococcal Cellulitis and Review of the Literature Archives of Iranian Medicine, Volume 12, Number 6, 2009: 591 - 594.