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Cellulitis in Child
See also in: Cellulitis DDx,Anogenital,Hair and Scalp,Oral Mucosal Lesion
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Cellulitis in Child

See also in: Cellulitis DDx,Anogenital,Hair and Scalp,Oral Mucosal Lesion
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Contributors: Sabrina Nurmohamed MD, Susan Burgin MD
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Synopsis

Cellulitis : Chills, Erythema, Lymphadenopathy, Lymphangitis, Skin warm to touch, Unilateral distribution, Blanching patch
Cellulitis is an inflammatory bacterial infection of the deep dermis and subcutaneous tissues often caused by Staphylococcus aureus or Group A streptococci. Haemophilus influenzae was formerly a common cause of head and neck cellulitis in children until routine H. influenzae type B (HiB) vaccination in developed countries. Streptococcus pneumoniae is a known cause of facial cellulitis. Other bacterial agents may be considered based on immunization status and age.

In cellulitis, bacteria invade through breaks in the skin including puncture wounds, dermatitis, and burns. Implantable cardiac devices can also cause infection. The clinical manifestations include rapidly progressive areas of skin edema, redness, heat, and pain with or without associated lymphangitis or lymphadenitis. Systemic symptoms of fever, malaise, and chills are common. In immunosuppressed individuals, the infection can spread to cause large abscesses, necrosis, and dissemination into blood. Predisposing factors include conditions that compromise the barrier function of the skin or weaken host defenses such as obesity, trauma, or chronic edema.

Although many cases of cellulitis are attributable to streptococci, it is important to be cognizant of the rising prevalence of methicillin-resistant S. aureus (MRSA). MRSA should be considered for purulent infections. In the outpatient setting, MRSA coverage should be added for nonresponse to beta-lactam therapy. For pediatric inpatients with cellulitis, guidelines suggest community acquired MRSA (CA-MRSA) coverage.

Related topics: Orbital Cellulitis, Preseptal Cellulitis

Codes

ICD10CM:
L03.90 – Cellulitis, unspecified

SNOMEDCT:
128045006 – Cellulitis

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Differential Diagnosis & Pitfalls

Deep tissue infection
Infectious
Inflammatory
Vascular
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Therapy

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References

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Last Reviewed:12/06/2016
Last Updated:05/20/2019
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